Sunday, 12 August 2018

Therapy is about Engagement, not Compliance!

I’ve been using the Attention Autism programme (Gina Davies) pretty much every day for the past two years and I can honestly say I don’t know how I did speech and language therapy without it. The basic principles of Attention Autism such as; the activities needing to be motivating, visual, appealing etc are our bread and butter skills as therapists but ensuring that everything I deliver is an irresistible invitation to learning is a completely new challenge.

Attention and listening are pre-requisite skills to language development and the time and effort we need to invest in supporting children both with and without Autism with this cannot be underestimated. After all, we need to ensure that our activities are indeed worth communicating about!

The Attention Autism programme consists of four stages:

-          Stage 1: ‘the Bucket’ – Focus

-          Stage 2: ‘the Attention Builder’ – Sustain

-          Stage 3: ‘the Interactive Game’ – Shift

-          Stage 4: ‘the Table activity’ – Transition
 


“I’ve got something in my bucket, in my bucket, in my bucket, I’ve got something in my bucket whatever can it be?”

 
Stage 1 is all about ‘the Bucket’! A bucket filled with simple, motivating and appealing toys that will capture the child’s attention. The main aim at this stage is to teach the child to independently focus on the adult-led agenda and to take the risk of trying something new.
As a ‘speech’ therapist the trickiest thing I found when I started was to try and not talk. Many children with speech and language difficulties find too much verbal information overloading which can result in ‘tuning out’. When delivering Attention Autism, I am now more confident to rely on the activities to bring the child’s engagement, not the language.

Now of course at the beginning, things went terribly wrong. Children kept getting up from their seats, others found it hard to transition to the activity and however prepared you are, you need to trust that it is ok for mistakes to happen. We cannot take the child’s cooperation, for, however short a time, for granted. The supporting adults need to resist trying to herd the children back to their chair as Attention Autism is about working on engagement not compliance. Remember: ‘if it’s Fun, they’ll come!’. Make your targets realistic, at Stage 1 aim for your children to attend for 1 minute initially and then build up slowly each day. If you deliver a fun and appealing session the children will learn to naturally and spontaneously self-regulate to the adult-led learning.

If we are expecting the child to tune in and attend straight away, then we need to ensure we are ‘selling the bucket heart and soul’.

Fun doesn’t mean Unstructured. Follow the rules.

1.       ‘It’s Tish’s bucket, it’s Tish’s toys’.

It may seem mean but only the leading adult is allowed to touch the toys. Many children have single challenged attention (Cooper, Moodley and Reynell 1997), so if they are playing with the toys, they are not focusing on you. Keep your distance so little hands don’t feel tempted to pick up the toys.

2.      Show first, add words later.

If you’re like me this part may be tricky to begin with. We may instinctively want to start adding in language, but it is important to stay quiet and allow for thinking time. Then gradually increase the language.

      3.      Everyone one is joining in – no exceptions!

Supporting adults need to keep modelling expected behaviours. If we begin talking amongst ourselves or getting up to ‘do a job’ we are only modelling to the children that it is acceptable to get up and leave the activity if you feel like it. Our children attend to the most dominate stimulus in the room – make sure it’s ‘the Bucket’.

     4.      Keep Calm it’s only a bucket.

However prepared you are, you’ll never be prepared enough for the unpredictability of working with children, which I tend to love about this job. Don’t get distracted by louder children, you’re the adult you dictate the start and finish of the session. Don’t let children getting up and wondering off fluster you, trust your supporting adults to bring them back silently. Rushing adds anxiety, so keep calm and enjoy the shared experience.

5.      Focusing leads to sustaining.

Aim to carry out the session 4/5 times a week, start at 1 minute and build up slowly. When 80% of your group can attend for 5 minutes, you’re ready for Stage 2 and remember

“if it’s fun, they’ll come!”

 

 



 

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