Community Outing

This morning we had another community outing, this time with Mohammad and his mother. Before deciding where to go we asked Mohammad’s mother where she typically takes him in the community and if there are any specific behaviors or shops that cause problems. She said sometimes he will have behaviors if there are loud babies screaming nearby and that in toy stores he often has difficulty giving up items he wants. With this in mind, we decided to head to a toy store first but told Mohammad’s mother she needs to communicate her expectations to Mohammad before they enter the store. This should include whether or not they will be buying anything today and also whether the purchase of a toy will be dependent on his good behavior. Mohammad was excited to get into the store and was very well behaved, eventually picking out a toy lazer gun.

Next we walked to the mall and did some clothes shopping. Mohammad’s mother told him he to wait until they returned home to open the toy and he listened well. Even when he was tempting himself by looking in the bag he would quickly shut it and say to himself “No! I must wait!” Adorable! Muhammad was not very keen on trying on clothes at the store and would scream while pushing the item away from him. After we got back to the center we talked to his mother and modeled how she can begin to shape his screaming into appropriate communication of rejection. However, when she went to practice with the sweatshirt she had purchased, he did not seem to mind trying it on so we talked about getting him used to changing clothes in different but more familiar environments to generalize that situation.

There is possibly one more community outing left. They have all been fun and the families say that they are beneficial.

-Daniel

Visiting a School and The Department of Social Work

After a full day of training yesterday, we had a slower day today.  Two of us joined Yousef at an annual meeting for the Department of Social Work for the local area.  It was their annual celebration of various accomplishments over the past year.  We have been meeting with them to plan a presentation to the social workers in the area.  They are interested in finding out how to help families in the area that have children with disabilities.  We are planning the presentation for next week, along with a presentation to the Department of Education.

After the meeting, we joined Yousef for a meeting at a local school.  He had a meeting scheduled there to discuss some plans for a cultural exchange program for some of the students.  We were able to talk with the principal about the school and about education and training for teachers in Jenin.  This was my first time visiting a local school, so it was interesting for me to see the school and to be able to find out more about the education system here.

Tomorrow, we will take another child and mother on a community outing.

-Sarah

Cooperative Skills Practice

For today’s skills practice training, we again split the families up into two groups. In the morning Adnan, Moayad, Abed, & Moataz’s mother were able to work on many of the skills they reviewed in Saturday’s training. Abed and Moayad are non-verbal so a lot of time was spent teaching them to point for things instead of grabbing. For Abed, this was easily practiced with a candy he liked. Since he was motivated by the candy, we used it as a reward for completing puzzles or other simple demands. Moayad did an amazing job requesting for computer videos to play. We were able to have all the parents rotate and help shape his reaching into pointing. After about 15 minutes he was pointing independently! It was a great teaching opportunity for the group and it helped them understand what their children should be doing when making requests.

(Daniel observes Adnan’s mother as she works with Moayad on the computer)

Adnan is verbal so instead of pointing for items we worked with him on verbal requests or tacts. Being the clever child that he is, Adnan was a little more challenging to motivate t0 work, so his mother did some intraverbal skills by singing and tried some manding with preferred toys. It is important to remember these children do not attend school and are not accustomed to hours of demands being placed on them so in the beginning the mothers will face a lot of resistance that we encourage them to work through.

In the afternoon we had Basil and Mohammad and their mothers. Basil worked on following directions with puzzles, imitation skills using playdough, and some manding with snacks. His mother practiced turning his reaching into pointing. Mohammad started off the session with tantrum behaviors so we used this opportunity to teach his mother how to ignore and to practice limiting the attention she gives him, even during instructions. Once we got him to comply with sitting in his chair we were able to do some tacting with colored cards and discovered his weak spot for tickles as reinforcement!!

 

(Sarah reinforces Mohammad by tickling him after he labels the color “blue”)

Next week we are excited to have six new families join our current families come and join at least 6 new families as we begin the next phase of our program by going over the autism overview training and expanding our support group. As introductions are made, we hope our current families will share their experiences learning ABA skills and techniques these last few months so the new families will see the value of ABA firsthand.

-Daniel

A Productive Sunday

Hello Global Voice for Autism fans,

I hope everyone is having a good Sunday. Today turned out to be a very productive day for us.  We started the day with our usual Sunday routine.  I listened to music while a few of my teammates went to the gym.

At 11:45, we headed to a meeting in order to set up some community outreach lectures.  Part of this project’s goal is to educate the community about autism.  It is very important to have individuals in the community who understand what autism looks like and what to expect when they meet people with autism in the community. Our team gives lectures to different community leaders and to organizations who work with the children of this community.  We are planning  a lecture for social workers who handle the cases of families in the Jenin community. First we had a meeting with the Minister of Social Work of Jenin.  Next week we will be giving a lecture to the municipality’s 20 social workers about autism.  This two-hour lecture will include an overview of the characteristics and symptoms associated with autism.

After our meeting with the Minister of Social Work, we went to meet with the Minister of Education. As we arrived at the Ministry of Education, we saw children of all ages filling the streets as school day ended.  We then met with the Minister of Education and and the Director of Education.  During this meeting we learned that there are 90 licensed kindergartens  in the city of Jenin. It is amazing to think that there are this many schools for children aged 5-6 in Jenin!  In order to meet the needs of all teachers and social workers in the Jenin community, we will be offering two lectures at the Ministry of Education.

After scheduling these events, our team met over lunch and talked about our experiences in the autism field.  We shared ideas on what it is like working in different environments and the challenges we have faced.  Hearing some of my teammates’ stories has helped me come to the conclusion  that although our country has made several advancements in providing services to individuals in need, there are still many  improvements to be made. Note: If I could have dinner with 10 famous people, alive or dead, one of them would be B.F. Skinner!

Our focus at the moment, however, is on the success of the Global Voice of Autism.  Tomorrow, our parents will come in a for another practice session.   We have scheduled two sessions with small groups of parents and children tomorrow to work on their ABA skills.  It is sure to be a wonderful day.  Check back with us to see what the day will have in store.

-Submitted by Katrina Walker

Sibling Reflections: Time with Siblings at Home

Last week we gave the siblings in our sibling support program a challenge to spend 10 minutes a day playing with their brother or sister with autism and to come back this week and tell us what they learned. The results were impressive. Every child came back with a story of their time playing with their sibling. Some even applied the basic ABA principles we taught them last week during their play. 

The children in our program still faced challenges when playing with their brothers and sisters and they know that those challenges will not disappear overnight, but using ABA, their knowledge of their sibling and their creativity they are motivated to continue helping their siblings and strengthening their relationships.

Check out what some of them had to say:

Haya* (9) sibling of Abed (5)-

“This week Abed and I spent time playing games, painting and playing in the garden together. While playing with him, I noticed that even though he does not talk, Abed is very clever. When my mother was getting ready to leave the house, she told us that she needed to get her scarf before she could leave. Abed heard her and went to find the scarf and brought it to her.”

“One of the hardest things about playing with Abed is getting him to play with me. Sometimes I try to play with him but he walks away and goes to play by himself. When he does this, I try to get his attention again by playing things that he likes to play. This worked and he came back to play with me”

Adham* (14) sibling of Mohammad (5)-

“Mohammad is still obsessed with my cell phone but this week I played catch with him, played soccer and helped him play with a remote-controlled car.”

“When I take my phone away from Mohammad he still cries until I give it back to him. Next week [After today’s group discussion] I am going to make him ask for it and am not going to give it to him when he cries. I want to be able to share my phone with Mohammad but I want us to take turns with it.”

“You should know that Mohammad learns very quickly and has a great memory. I have a dot password on my phone and after watching me unlock my phone only ONCE he knows the password and remembers it every time!”

Taha* (9) sibling of Adnan (11)-

“This week I learned that Adnan knows how to write and how to color so we practiced writing and coloring. We also played soccer, played with sand and played with trucks. When Adnan wanted to play with something this week, I made him say “I want that” in order to get it. I got him to ask for small cars, plastic trucks and play dough and only gave him these things when he asked for them.”

After the discussion, we helped the siblings create some more activities that they can play with their brothers and sisters with autism at home. First we made “Memory” games where they can take turns trying to match cards in pairs. Later we made “rain sticks” by filling water bottles with rice and beans and decorating them with stickers. 

 

 

(Siblings making a “Memory” game to play with their sibling at home)

 

(Working on rain sticks)

 

We finished the day by playing some games with the siblings that centered around the point that their brothers and siblings with autism may learn differently than they do. For the first game, one of our translators stood in the corner and gave instructions like “clap your hands” and “stand up” in a whisper. When the children said that they could not hear, we switched the game up and gave the directions in English. After the game we discussed how sensory challenges and difficulty with auditory learning might affect some individuals’ with autism and might make it difficult for them to participate in certain activities.

For the second game we had the children pair up and then brought one child from each partner into the next room. While their partners were out of hearing distance, we explained the rules of a lego building task to them and instructed them to go back in and explain the task to their partners without talking. After completing the task we had a group discussion about the strategies they used. All of the partners talked about visually demonstrating and using hand gestures to instruct their partners. They noted that these are strategies that they can also use to help their siblings if they are struggling with a task.

We ended the support group by challenging participants to spend time with their siblings every day this week and to continue using the strategies we discussed in order to work through the difficulties they might be having. 

While we were having sibling support downstairs, the mothers went through a toilet training and life skills training with Sarah and took a quiz about the skills they have learned so far. The mothers were looking forward to this training and said that they were very happy to have the knowledge to work on toilet training with their children at home.

-Melissa Diamond

Everyone Should Read This Article!

Here is an excellent article by a teacher on the autism spectrum. While we do the best work we can to help individuals with autism and their families, nothing compares to work for the autism community, by the autism community. We hope that wonderful people like this continue to get the recognition they deserve!: http://www.autismspeaks.org/blog/2014/02/20/heart-autism-teacher-spectrum-inspires-students-autism

*Sidenote: We are aware that there were some clashes in Hebron today (a city 3-4 hours from Jenin) and we just want to let our international support base know that we are safe and that the situation in Jenin continues to be calm. We will keep you updated on our safety and let you know if any concerns arise.

Check back tomorrow for updates on our toileting training session and our “How can I interact with my sibling” sibling support group!

Thank you for your support!

-Melissa Diamond

Preparation Day

Today was a day to prepare for our upcoming trainings on Saturday and Monday.  We spent time reviewing the material that we will work on with the parents this weekend.  This is the last training in the series.  We will go over toiletting and how to teach other self-help/adaptive skills to the parents.  The mothers have been eagerly awaiting this training.  We will also spend some time on teaching them about some specific teaching strategies in Applied Behavior Analysis, like chaining, how to write a task analysis, and different types of prompts.  We also hope to have time this week to review the functions of behavior and do an evaluation with the parents to see how much of the material they are absorbing.  We also talked about our plan for training on Monday and will again split the parents and their children into two groups in order to work more individually with them and have the parents practice with another child.  Katrina and Melissa also planned their sibling support group activities for Saturday.

As we look forward to the next round of training, our plan is to start the training with new families, but continue to include the mothers and their children from this round.  We also hope to utilize the knowledge that they have learned over the last several weeks to help train the new mothers.

Sarah

Basil’s Community Outing

Hello Global Voice for Autism Friends,

It’s Hump Day Wednesday as we say in the U.S.  This means that the weekend is not far away!  In fact, here in Jenin, Friday is the weekend, which means that the weekend is even closer!  I hope your week has gotten off to a great start.  Our day started with a community outing for Aseel and her son Basil.  Basil is a great kid!  He is non-verbal but can do many things.  He loves playing with plastic animals and being tickled.  However, Basil also likes to wander.  This morning when he came to the center, as a matter of fact, he gave us a big surprise!  As my team and I prepared for the outing, Basil decided that he wanted to come and visit.  On several occasions, Basil opened the door to our room and walked in!  He wandered in and out of our room looking for his favorite toys without ever acknowledging that we were there.

Our community outing was great despite Basil’s prior wandering behavior.  Our team followed Basil and his mother to a nearby mall to shop.  When we arrived, Basil’s mother told us that he obsesses about going up and down escalators.  Fortunately, when we reached the top of the escalator, Basil was compliant.  As a reward for going up the escalator and not trying to go back down, his mother presented him with one of his favorite toy animals (the camel) from the center.

We then visited a women’s clothing store and a children’s store.  For Basil, these stores seemed to be more of a challenge.  While in the first store, Basil began looking in his mother’s purse.  This was a clear sign that he wanted something. However, his inability to verbally communicate made it impossible for us to determine what he wanted.  It is important to understand that when working with children with autism, they sometimes exhibit problem behavior as result of a failure to communicate their wants and/or needs. Basil began to show signs of frustration.  We waited for Basil to calm down and then left the store.

In the last store,  Aseel was able to walk around the store browsing through children’s clothes with Basil holding her hand and/or staying close by.  This behavior was an improvement from the previous store.  As a reward, his mother took him to buy a toy horse he had admired when we first arrived in the mall.

For our last activity with Basil and his mother, we walked with them to a snack shop in the mall.   His mother purchased a snack for him, however, Basil began to grab other things he wanted to eat as well.   With this opportunity Aseel prompted her son to point to what he wanted.  After several attempts, Basil successfully made a choice of the item he wanted.
As Basil sat with his mother eating his snack and playing with his new toy, he exhibited no problem behaviors.  When presented with a bottle of water and a snack cake, Basil was given another opportunity to communicate with his mother about the item he wanted.  It is important for parents to remember to take advantage of opportunities similar to this one when the goal is to teach a non-verbal child to mand.  In this case, Basil was given a full physical prompt to point to the item he wanted.  It is also important to immediately honor a successful mand once it has been given.

(Basil enjoying his snack at the mall during his community outing)

As Basil finished his snack, we headed back to center to debrief the outing with Aseel.  We reminded her to only give instructions once and to follow through with demands that she places on Basil, giving prompts when necessary. She told us that she continues to work with Basil at home and that sometimes she has difficulty engaging him in activities, but that once she is able to engage him, he does well.

-Katrina Walker

Workouts and Burqeen

With no trainings scheduled for today, some of our team used the morning to get some exercise at the local gym. It was apparently fairly crowded, which might be partly due to the fact that exercise time limited because it is segregated by gender. They have all the usual gym exercise machines, free weights, as well as a sauna, hot tub, and group fitness room. Melissa even (accidentally) joined a Zumba exercise program today.

This afternoon Sarah and I made a trip back out to Burqeen to show Sarah the Orthodox Church there and do some hiking. They had finished working on the inside of the school room that was still under construction at our last visit. I was also able to climb down the mystery hole to discover the cellar where they use to keep food and supplies. Some of our translators came to the center to visit this afternoon as well.

This evening we talked about our next community outing and decided to make a few changes in how we approached the activity so that the outing will be more appropriate for the child we will take tomorrow. I can’t wait for tomorrow!

-Daniel

Modeling Practice

The families were split into two groups for training practice today. The morning session included Adnan, Ahmad, Abed, and Moayad. We had the mothers work in a separate room from their children during this session. In the room with the mothers, Sarah started by demonstrating the skills they were going to practice by modeling with Melissa and myself. After the mothers practiced with each other, taking turns pretending to be the children, we brought in one child at a time for a short work session. Abed was able to give up preferred items without behaviors which gave him the most opportunities to practice mands. Adnan and Moayad were less interested in working for their preferred items, but by then end of the session everyone got a little practice in.

(Basil plays as he waits to practice manding with his mother)

The afternoon group included Mohammad, Basil, and Moataz’s mother and went well also. We discovered Mohammad enjoys strumming the guitar, and his mother did a great job incorporating manding practice with teaching Mohammad to tact guitar and music. Basil also had some independent non-verbal mands as well as success with an animal puzzle. Overall it was another great practice day for all our families.

(Basil and Mohammad play a fishing game as they wait for their parents to finish training)

The mothers tell us that these modeling sessions are very helpful as they work to fine-tune their ABA skills.

Wednesday we have scheduled a community outing with Yamen. We have outings pending with the last 3 families who have not yet had outing for Thursday. Yay for community outings!!

-Daniel