Saturday, 11 August 2018

assessing a demand avoidant child...... yes you may look stupid but who cares?

I've just handed over a new case to one of my colleagues and as I was telling her about him, I also discussed that I'd had a new student with me when I met him. Having someone else observing made me reflect on how we interact with  children who are harder to engage but there's not much written about it as a guide for school aged, especially, if they are demand avoidant. I saw myself through her eyes and realised I definitely did look stupid and it probably wasn't how she was expecting a 50-something professional to behave! However, it was exactly what the situation demanded. If I can use the dog, it really helps but on this occasion, he was scared of dogs so Ralph wasn't there.

Many of the pre-school Hanen tips still work well:

1. Observe, wait, listen: ask parents what they're interested in and watch and listen closely. He used sound bites and little scripts acting out situations, as the main part of his expressive language. These included zombies, teleporting and fighting. We hadn't finished what I needed to cover when he'd thrown me out of the play room as he hated me and 'couldnt stand' me any more, I crept out out of a second door and burst in telling him I'd teleported. He forgot he was cross with me and asked me to 'Do it again!'. Of course, I  can only do it once a day, so maybe next time.  A little while later, he ran outside and wouldn't come back when we asked, so I pretended to be a horse, crying 'Jump on I'll save you from the zombies!' He did and we piggy-backed back into the playroom.

2. Get down on their level: you can see their facial expressions so much better if you're on the floor with them but they're level, so you are seen as more equal. This is far less stressful for them and you're more likely to get them talking if they feel equal. Sitting at a desk would have been impossible anyway! We did an expressive language sample while we were both colouring our pictures in.

3. Follow their lead, follow their interests: I didn't direct him very much really, I used books, toys and games he wanted to use. I asked him to choose each time. I had the Dewart and Summers pragmatic checklist his mother had completed and was able to interview her at length so it didn't matter that I couldn't do anything formal. I got a really good measure of his abilities and what he needs help with

4. Use a low-arousal approach. This Approach emphasises a range of 'strategies that focus on the reduction of stress, fear and frustration and seeks to prevent aggression and crisis situations'. The low arousal approach seeks to understand the role of the ‘situation’ by identifying triggers and using low intensity strategies and solutions to avoid punitive consequences. I keep calm whatever the situation throws at me (physically and verbally). His mother uses humour as part of this approach, brilliantly to deflect, move him on and get him on-side.

5. Never take things personally. Demand avoidant children may call you names (I know I'm 'old, fat and ugly' so nothing new there), may try to shock you verbally or physically or threaten you. We need to see it for what it is, an attempt to get out of a stressful situation.

6. Have the confidence not to mind what other people think: just as with pre-school ones you can burst into song, do unexpected silly things, pretend not to know.... As long as you can justify it....do it if the situation demands! Fortunately the student turned out to be brilliant and she didn't see me as some crazy old woman. She understands we have to do what it takes!

I was able to report on his attention, listening, understanding, vocabulary, expressive language and social thinking skills. The real hard SLT work will be done by my colleague as she sees him for therapy. The real hero? His mother.
Hanen www.hanen.org
Low arousal http://www.lowarousal.com/

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