Routines to help children get started

Q: What do you do with the child who can't seem to get organised in the morning?

A1: Have a set routine - repetition and rehearsal replaces the difficulties caused by executive functioning issues. It means that the routine becomes automatic - you don't have to think, analyse, prioritise or plan. So do the same things, in the same order to start the day.

A2: Use visuals - especially for young children or children with language and/or literacy difficulties.
A3: Use checklists - especially for older children or children who have good literacy skills. You can do this on little whiteboards, or you can use a table like the one at www.do2learn.com.

A4: Have a time frame - leaving time open can increase the chances that the child will daydream, or spend too much time focusing on details rather than the sequence of things they need to get done.

I recently went to a workshop by Dr Lee Sturgeon where he talked about the use of a Time Timer. This is a great tool that will help children keep track of how time is passing. You can find information on the different formats on the following links:

• Spectronics - find the watches, clocks and software application here.
• The iphone application can be found here.
  
• Find the complete package here - iphone application, software version and traditional clock version.
  

Q: What do you do with the child who takes ages to get settled in class?

A1: The same as might be done at home: have a set routine. This might involve a simple routine that determines the sequence in which the necessary equipment for the day is unpacked. Or it may simply be a routine such as:

• Line up
• Walk in quietly
• Sit down
• Get out your pens and books
• Look at the teacher
  

A2: Again, as with home, use visuals to represent your routine.

A3: Use checklists and advanced organisers. For example, this chain of events graphic organiser from educationoasis.com. You can find more here and here.

A4: Have a time frame - this is very important in classrooms as children with executive functioning issues often get "left-behind" at the beginning of lessons as they struggle to get organised and started. This can then have a significant impact on the rest of the lesson - or the rest of the day.

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Getting Started takes initiative

Children with executive functioning issues can find it very hard to get started and persist with a task (Kidsmatter, 2009; Queensland Health, 2007). This is due to the "initiation" element of executive functioning.

One of the reasons why children with executive functioning issues have this difficulty is because they find it hard to filter, or prioritise, activities and information (Dodd, 2005).


An Example

Have you ever woken up on a day when there are a hundred different things you need to do? How do you decide on what to start with?

One way we make decisions on where to get started is by identifying what is most urgent or important. But this requires the ability to identify what our goals are (planning) and what we are able to do in the time we have with the skills we have (self-evaluation). So if you have trouble with all these things, you could:

• Spend all day lying in bed stressing about where/when/how to start
• Start a range of tasks and never get them finished as you get distracted by the possibility that you are not focusing on the most important task.
  
• Choose something randomly, with a high chance that the task turns out to be one that you could have done another time, while a more urgent task goes untouched.

As you can imagine, this can have a significant impact socially, academically and in every day tasks for children with executive functioning issues.


At home

Due to this struggle with initiation, children will find it difficult to:

• get ready for school on time
• follow every-day routines without verbal, written or visual reminders
• clean their room without being distracted by a favourite book, toy or TV show

At school

Due to the struggle with initiation, children will find it difficult to:

• Concentrate on the task at hand without being distracted by what is going on around them
• Get organised and ready to start at the beginning of a lesson
• Finishing what they have started

In the next few posts we will explore how we can help children prioritise, organise and stay on track even if they do have executive functioning issues.

References

Dodd, S. (2005). Understanding Autism. Sydney: Elsevier.

Kidsmatter (2009). How Attention Deficit Hyperactivity Disorder (ADHD) affects children. Retrieved 8th May 2010 from http://www.kidsmatter.edu.au/wp/wp-content/uploads/2009/09/adhd-overview.pdf

Queensland Health. (2007). Executive Function and Capacity. Retrieved 8th May, 2010 from http://www.health.qld.gov.au/abios/documents/behaviour_mgt/exec_functn_capacity.pdf.

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Introducing Rainbowland Autism Services...

Guest post by Allison Dix from Rainbowland Autism Services....

Our Family...
Our three children were all diagnosed as having an autism spectrum disorder in July 2007. Kristie, who was 8 at the time, was diagnosed with a Asperger’s Syndrome. Our twin sons, Jacob and Aaron, were diagnosed with autism one week shy of their 3rd birthday.


Rainbow Play TimeShortly following the diagnosis, Shane and I vowed to help support families through the whole process as we intently believed that it didn’t have to be as difficult for others as it was for us. This vow lead to the inception of our family support group, Rainbowland Play Time in March 2009. With a focus on family inclusion and support, this group runs once a month on a Sunday, has no age limits and welcomes the entire family and their support networks to attend for a gold coin donation.

Rainbowland Play Time has been a gift not just to the families who attend, but to our family. We have made some wonderful friends and been witness to some fabulous milestones experienced by the children and their families. My favourite moments have been when children ride a bike for the first time at Play Time. The delight on the face of the child and their parents is so precious and makes it all so worthwhile.


Into the political arena...
Shane & I were fortunate enough to be selected for a meeting with the Prime Minister, Kevin Rudd, at the Federal Cabinet Meeting & Public Forum held on 28th July 2009. We raised issues pertaining to the inaccessibility of the newly implemented early intervention funding from the Helping Children with Autism initiative, the crisis and inequities for children with autism within the education systems around the country and the struggles faced by families. To our surprise, we were also granted an impromptu meeting with the Parliamentary Secretary for Disabilities and Children Services, Bill Shorten.


Rainbowland Autism Services...

Rainbowland Autism Services Inc. was incorporated in November 2009 and granted charity status. A board, comprising of 6 members was established. The incorporation of the organisation will ensure much greater opportunities for the families it supports.


Autism Rainbow Day...

After a family discussion in the kitchen regarding the lack of autism awareness within the community and how more awareness would greatly benefit families and society at large, Autism Rainbow Day was born. On 30th April this year, the inaugural Autism Rainbow Day was held, with 15,000 international members on the dedicated Facebook cause. The day was very uplifting and positive for those who participated and it was wonderful to see people greeting others with a “Happy Autism Rainbow Day”.

I have received some wonderful feedback from educators about how they now have a much greater appreciation of what autism is and how inspired they are when learning about the obstacles that need to be overcome for people on the spectrum to become functioning members of society. Our daughter’s Year 6 class teacher initiated meaningful discussions about autism throughout the week in the lead-up up to Autism Rainbow Day and Kristie’s life and achievements were celebrated by her peers. What has been really touching is how some young students from the school have since approached me in the court yard to talk about Autism Rainbow Day. I also got quite emotional when I saw pictures of the children wearing their special masks on the big screen at the school assembly. Autism Rainbow Day will be held on Friday 29th April in 2011.


A Tribute...

On 13th May this year, Tony Zappia – Federal Member for Makin paid tribute to the work we are doing through Rainbowland Play Time and Autism Rainbow Day. It was such an honour for us that he dedicated his entire Parliamentary Speech to our work.

In his speech, Tony says:

“In Australia autism is estimated to affect one in every 160 Australian children and around 30,000 Australian families. The estimated cost of autism to the Australian community is around $7 billion per annum. The social impacts on and costs to the children and those 30,000 families in the form of learning difficulties, limited social opportunities for the children and very high rates of parental depression and separation are immeasurable. There is no cure for autism but providing the right kind of early intervention can be very beneficial for children and, in turn, ultimately saves millions of dollars in costs later on.”

He then went on to say:

“Speech therapy, early intervention, occupational therapy and home modifications all help, but for the families they come at a cost, as does the destruction to the school life of the children, which raises an additional concern. Many schools are simply unprepared; they do not have the resources or the expertise to deal with children with autism. In that respect, autism-specific preschools such as that in Brisbane are a terrific start.”

To read the speech in full, visit our Facebook note or at: www.openaustralia.org

Tony has been such a wonderful support to our organisation and is the Patron of Rainbowland Play Time. Through his work, he is also advocating for all families living with autism in Australia.


Our goal...

Rainbowland Autism Services strives to provide support services for the entire family. When you support the network of people who are the main influence in a child’s life, you are directly supporting the child. We also provide support to families of children with developmental delay. Too often these families don’t have access to support services in the absence of an ASD diagnosis. We continue to work assiduously in expanding our support services and generating awareness about autism at a global level through Autism Rainbow Day.


For more information, you can visit our website at www.rainbowlandautismservices.com, or email us at rainbowlandautismservices @ gmail.com

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To find out more about having your charity, service or business spotlighted here, contact us or visit www.learn2bebuddies.com.au

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Ask Amanda: An update and a review

As usual, with the mad rush to get the Learn to be Buddies newsletter out, I have neglected my blog for a little while. Now the rush is over, it is time to get back to it ....

About our theme

Because executive functioning is such a complex and important topic, and I didn't get very far with it last month, I will continue writing on this topic this month. But before I start writing on this theme, I thought I would mention two things...


A Spotlight...

As part of the Learn to be Buddies sponsorship scheme, we are beginning a monthly spotlight on charities or businesses that a particularly relevant to the Learn to be Buddies mission. This month we are spotlighting Rainbowland Autism Services. Make sure you check out their services and support their cause. Shortly Allison will be writing a post for us to tell us all about what these are.


A review...

I also wanted to share a little from the workshop by Dr. Lee Sturgeon that I attended recently. I shared some information that related to bullying on my Learning to be Buddies Series blog. But here I just wanted to share some of the answers Lee gave to questions asked by parents in the audience.

Toilet Training Tips

Lee was asked about any tips he could give for a situation where a child was fully toilet-trained at home, but was struggling to use the toilets at preschool. His suggestions included:

• Try giving the child access to a private toilet, such as the staff bathroom. It may be the fact that they have to use a public toilet ("in a fishbowl" was Lee's analogy) that is putting the child off using the toilet at preschool.
• Video the child if/when they do use the toilet, then watch it and praise the child for that behaviour at home (applied behaviour analysis). My note: You as a parent may need to do this as many preschools would be reluctant to tape so intrusive a video. Lee's tip about using video as a teaching tool: Make sure you focus on the positive rather than video-ing something you don't want them to do, watching it and saying "Don't do this."
• When toilet training a child with ASD, make sure you do so with a range of different toilets - not just stick to one. This helps them generalise the skill, or use the skill in a wide range of settings not, as Lee said, "just in the ensuite at home."
  

Service accessibility

There were a number of parents who were asking about how/where they could access services for their children due to the limited availability and long waiting lists for Medicare and FAHCSIA funded services. Lee talked about asking your GP to establish an Enhanced Primary Care Plan or a Mental Health Plan, both options allowing parents to access Medicare refunds for private consultants and therapists.


Medication

Another question that came up was the issue of medicating children with Autism Spectrum Disorders. Lee talked about the fact that many children with Autism Spectrum Disorders have a secondary diagnosis. For example, they may also be diagnosed with anxiety disorders or ADHD.

He suggested that it is usually these secondary diagnoses that lead to medication. He stated that he used medication for his clients especially for anxiety in the middle school or adolescent years. His statistic was that 40% of children in transition to high school were on medication to help them deal with anxiety.

However, he had one emphatic warning: Make sure you see a specialist in the field of Autism/Aspergers for the prescribing of medication. The main reason is that children with Autism Spectrum disorders often respond differently to medication than do their peers without these disorders.

As you can tell, this workshop was great. It was also free, thanks to a government initiative. I will keep my eye out and let you all know if there is another on coming up in the future.


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