Scripts and Social Stories

Scripts

I often say that JC has "scripts" for various social situations and when these scripts aren't followed, his anxiety level rises and he often cannot function.
Think for a  minute if you went to a foreign country.  Rather than driving on the right side of the road, everyone drove on the left. And what if instead of eating at the table, you ate on the floor. And instead of sleeping in a hotel room you slept outside.  Twins would all be very unnerving.  ESPECIALLY if no one warned you about it.
JC relies on routines so heavily to give him the understanding of what to expect in situations. He then develops a script in his mind as to what that situation should look like (for us, things like: we drive on the right side of the road, we eat at a table, we sleep in a bed in a hotel).  And if that script changes (especially without notice) his expectations aren't met and he cannot adjust by himself.

I think of it like this:
JC lives in a box - his comfort zone.  He has all of his rules and scripts setup inside that box like wallpaper.  Sometimes he allows someone in there with him, but they have to also follow his scripts or he quickly kicks them out.  Occasionally he will venture outside of his box, but quickly retreats back inside the safety of that comfort zone when life gets overwhelming.   The walls of the box are always changing.  Sometimes, they are like clear plexi-glass.  He can look through to the outside world and sometimes interacts by meeting you half way.  And other times, the walls are made out of bricks and there is no getting in or out.  The majority of the time, I would say the walls are made out of sticks.  Strong, but able to be permeated with the right tools.  And just like we build our houses to protect us from the elements or rain, wind and sun - JC has built his box to protect himself from the unknown, the unexpected, and the unexplained elements of his world.

So how do we get through into JC's box?  Certainly not by knocking the walls down like the big bad wolf or trying to drag him out kicking and screaming.  We have to remember that this box serves a purpose for him.  So we work to be included in the box, then from the inside out we can gradually adjust the structure, add to or change the scripts and maybe chip away bit by bit at the rigid walls.

This is why we use visual aides and social stories.

What are Social Stories?

Social stories help explain what is expected in certain situations. They can be simple short stories (we use pictures along with them) that describe a social situation and give the child a "script" to follow when one is not readily available already.  For our example above, it would be like sending us to a foreign country with a guide book that says "we drive on the left side of the road, eat on the floor and sleep outside".  All of a sudden our experience isn't surrounded by anxiety and uncertainty.  We may not like it - its still outside of our comfort zone - but at least we know what to expect.

Social Stories contain certain types of sentences that describe social situations and explain in detail what is expected in those situations.

• Descriptive Sentences: these are statements of fact... e.g: "Sometimes I ask for a cookie"
• Perspective Sentences: these are statements that refer to or describe an individual’s internal state, their thoughts, feelings, beliefs, or physical condition…e.g. “I like cookies"
• Directive Sentences: these describe desired responses to social situations... e.g. "If Mommy says "no" I don't scream or cry"
• Affirmative Sentences: these often express a commonly shared value or opinion within a given culture…e.g. “I can wait or choose something else"

It seems simplistic but after hearing the story several times, the concept is engrained and when the situation arises, a simple reminder will help ease the anxiety of the situation.

In addition to molding behaviors, another important reason to use social stories is to provide preparation for the unknown. We went on vacation recently and used a social story so that JC would have a preview of what to expect so that all of the new sights and activities wouldn't overwhelm him. They are a useful tool, along with visual schedules and first/then cards to alleviate stress in day to day activities.

Pinwheels: A lesson in Life

Pinwheels are a staple of childhood.  They are so simplistic in their design, but seem magical to a toddler.  JC was playing with a pinwheel last night, or at least trying to.  He knew that blowing on it should make it spin, but it wasn't quite working for him.  He couldn't get his mouth puckered the right way to blow a single stream of air.  His attempt was more like a heavy breath so the pinwheel wouldn't move.  He struggles with mouth movements (which is part of his issue with speech) and only recently successfully "puckered up" for a kiss :)

As the pinwheel sat lifeless, his frustration level started to rise so I sat beside him to help.  We both held the stem and we sat face to face with the pinwheel between us.  As he would blow his heavy breath, I would secretly blow a directed stream of air to make the pinwheel turn.  His eyes lit up with excitement!  Once again, he faltered the mouth position and tried his best to blow - as I blew and the pinwheel started to spin he squealed with delight.  This continued for quite some time and as I sat there I realized what an amazing moment this was.  It wasn't just playtime with a pinwheel, it was a moment when we were both acting as one.  I was replacing his breath with mine.  I was filling in the blanks where he wasn't able to do so.  I was providing a chance for him to succeed where he had previously failed.  It was an opportunity to show JC that even those things that frustrate him can be overcome... that by perservering through difficulties magical things can happen.  Maybe next time he picks up the pinwheel, I won't be right there using my breath to make it spin, and maybe he will again be frustrated that his efforts are in vain.  But then again, maybe he will remember that it CAN be done and he will keep trying.  At that moment, I felt that fleeting feeling that I was making the world easier for my little guy.  And I wished that every frustration could be eliminated that easily.  I would breathe every breath for him, to make his world easier.

Ready for Summer: Planning with Visual Strategies

(Much of the first part of this post is updated from a previous post... but made relevant to summer planning)

Summer is coming, the kids will be out of school and for me that means one thing... Panic mode!  I'm not sure about you, but I often have nightmares about being home alone with my kids and having no way to entertain them (well, maybe not nightmares, really...  More like anxiety, fear, and panic).  My oldest, BB, is 7 and requires constant movement and conversation or he will completely implode. My youngest, JC, is 2.5 and has Autism, sensory processing disorder, a speech delay. He requires constant attention, redirection and adherence to specific routines or he will implode.  I am left in the middle trying to keep both kids happy, while trying not to implode myself!

I have been planning for the impending summer craze for several weeks.  JC has difficulty when his daily routine is altered, so what is going to happen when we don't follow this routine any longer?  Luckily, I have a solution.  My plan is to build on what already works.

I have been utilizing visual strategies with JC for several months.  Visual strategies can consist of visual schedules, choice cards, first/then cards or any other visual tool used to help in the planning, organizing, remembering or completing tasks.  It may consist of pictures for younger children or those who are illiterate or it may be words or lists for older children. The use of visual cues helps to organize the task or daily activities making the expectations clear and understandable. This reduces anxiety and alleviates mental stress.

Why are Visual Schedules, Choice cards, and First/Then cards so important?

Visual Schedules, Choice Cards, First/Then cards are all "tools" that I rely on very heavily.  For JC, understanding verbal instructions or grasping auditory information in the mix of an overstimulating environment is very difficult.  It takes him longer to process information that he hears than that which he sees for a variety of reasons, many of which I don't fully understand (yet).

Primarily, it seems that his mind works more visually. He cues into words and seems to need a visual image of that word to process it. In the case of verbal language, if his brain takes a word and then creates a corresponding image before processing the word, then it makes sense that the processing time would be longer.  A perfect example of this is food choice.  If I ask JC, "what do you want to eat?" there is never a response. It is too much for his brain to process.  For us, it's a simple question.  But for JC, the search through his memory for all the food choices and then the process of labeling each one with a word is just too many steps.  Now if I ask, "do you want a banana or toast" that CHOICE makes it a little easier, but often there is still no response until I use a visual cue showing a picture of a banana and a picture of toast.  Then (and only then) will he make a choice by pointing to the picture.  It's like having a multiple choice test.  Choosing an answer from 4 given choices is easier than answering with an essay from memory. This is why Choice Cards are so helpful for JC.  And because it takes his brain takes longer and uses more energy to process those simple tasks that we take for granted, he is overwhelmed more easily and has mental fatigue after simple tasks.  His daily activities leave him feeling the way I used to feel after a long day at work working with a budgeting committee to iron out corporate budgets.  It's mentally exhausting.  Using the visual cues to alleviate that demand on his brain for these simple tasks frees up that energy to be used elsewhere throughout the day which means his overall mood and emotional/mental state is much better.
Click HERE to watch this in action!

Think about why we make "To Do" lists.  I often have so many things floating around in my mind that I start to get anxious that I'm not going to finish then all. So I make a list. This helps to organize my thoughts and provides a visual system which I can refer to and "check off" when complete.

Also consider the power of visual cues.  When we eat at a restaurant, they put pictures on the menu for a reason... Because it is powerful.  I am a lover of Pinterest, the ultimate visual choice board (many of the ideas below came from pinterest). We would never read all of those articles in activities for children and recipes or cleaning tips.  But with a pictures, suddenly it all becomes easy to process. We are all visual by nature, but some are even more so.

Visual Schedules:

We rely on the visual cues for many aspects of daily life, not just food choices.  I have 3 different "schedules" that I use daily: morning, afternoon and evening. I adjust the schedule according to our daily plans, and seeing that schedule gives jc an understanding of what the expectations are for that period.
Morning: eat, diaper change, get dressed, go in the car, go to school
Afternoon: eat lunch, diaper change, nap, table/work times, choice time (where JC chooses activities to do)
Evening: eat, play outside, bath, get dressed, book, bedtime

JC understands how this works and if we are having a difficult time in the mornings, I can rely on the schedule to say "look, we ate, now we need to get dressed so that we can go to school". It is amazing what a difference those visual cues make in that simple conversation.

I also have schedules for specific routines like bath time and teeth brushing. JC hates to wash his hair and face. It is has always been a battle.  But with the bath time routine schedule, the pictures show: clothes off, get in tub, wash body, wash hair, dry with towel, all done.  The very first time I used that routine/schedule, JC washed his hair.... Simply because the picture told him too. His visual processing is very strong, and he relies heavily on it so I am learning to use that to my advantage.

Choice Cards:

We use choice cards to allow JC to have some control over his activities.  I can choose some predetermined activities or foods and he can choose what he wants.  It also helps lot limit the endless choices which can sometimes become overwhelming. JC has a difficulty focusing on a take for an extended period. And transitions are also difficult. The choice cards are useful in both of these situations. Imagine being surrounded by a room full of toys and activities and being told to choose only 1. For JC, this is difficult. So allowing him to choose from a few choices with visual pictures makes this choice easier. I also often allow him to choose 2 or 3 activities and we work on transitions. First we do activity 1, he may loose interest flutter around the room after only a minute and at that point I refer to the visual cues and say "you choose cars, are you all done with cars". When he replies "all done cars" we move on to the next activity on his card (which he choose). This models appropriate transitioning and focusing. He cannot move from one activity until he is finished with it, and if he chooses to do an activity, he must follow through with it. It also helps reinforce the importance and adherence to the visual schedule structure.

First /Then cards:

This is my favorite :)  This allows me to direct behavior that I want by using the a goal system. First put shoes on... Then go outside.  First eat, Then you can have a cookie. It works amazingly well!  So well in fact, that I have been able to forgo the pictures in many cases and just use the verbiage: "First... then..." And he understands the directions verbally.  We are making progress!

Think about why we make "To Do" lists.  I often have so many things floating around in my mind that I start to get anxious that I'm not going to finish then all. So I make a list. This helps to organize my thoughts and provides a visual system which I can refer to and "check off" when complete.

Also consider the power of visual cues.  When we eat at a restaurant, they put pictures on the menu for a reason... Because it is powerful.  I am a lover of Pinterest, the ultimate visual choice board. We would never read all of those articles in activities for children and recipes or cleaning tips.  But with a pictures, suddenly it all becomes easy to process. We are all visual by nature, but some are even more so.

These visual strategies have helped me to bridge the gap in his communication ability making daily life much more manageable. In planning for the summer, I can rely on the use of this system that is already in place by simply altering the tasks each day.

How do I create a visual system?

There are loads of ways to create a system, and its all about what will work for your child. I like using laminated cards with Velcro tabs which make it easy to customize for the day or activity or need. Magnets work well too but Velcro is less expensive and more portable. I keep all of my pictures and cards in a folder with different sections for food, activities, schedules etc.  
I used clip art for specific pictures that related to our needs. You can also purchase memberships to websites or order sets online. For JC, eating is a huge issue, so many of my pictures are centered around meals and foods.

If you are just getting started, sit down and make a list of what you would like the visual system to assist your child with on a daily basis. If it is certain behaviors, perhaps a First/Then card would suffice.  If your child has difficulties with communication, you may find the choice cards helpful.  Or if your child needs strict adherence to a schedule or routine, the visual schedule will be helpful. We use a combination of all 3 so I used clipart for foods, behaviors (no running, no yelling, no hitting, ask for help etc), play choices, and routines like teeth brushing and potty training. Your pictures choices will depend on your needs.

Once you have an idea of where to start, search for images that you want to use (unless you are purchasing a ready-made system). For example, I searched google for "visual schedule no hit" and got a variety of images showing a child hitting and a red line through it.  I picked my favorite and copied it into a Word document to get started. Once I had my "library" or images I printed, cut and laminated. Then I created the cards by simply using a printed document with colored squares, which I laminated and attached Velcro.
There are also websites that allow you to print pre-determined images.  www.do2learn.com is one that is very helpful.


Food for thought:  I had favorite grocery store.  A few years ago, they remodeled and moved EVERYTHING. The first time I visited the newly designed store, I left in frustration because I couldn't find anything and I missed the comfortable feeling of my old store.  It took me several trips (and I actually found a new favorite store for a while) before I became accustomed to the new layout. My routine had been changed and it was such a shock to my system that I actually left the store and found a new store to shop in.  What would have helped?  Perhaps more notice?  Maybe a map of the new store?  So think of these visual strategies as a "map" for your child's day. Use it in whatever way works best for you and for your child. I tweaked my system several times before I got it just right.

For more ideas and examples of Visual Strategies you can also visit my Pinterest page: http://pinterest.com/JCsSPDMommy/

How do I start implementing this visual system?

If you're looking to implement a type of visual system, start now.  It will help in the long run if your child already relies on the visual schedule in some aspect so that they are exposed to the concept before the start of summer.

I started with the First /Then cards. It is only 2 pictures, it isn't overwhelming for the child and it supports behaviors that you need to encourage.
Start with 2 preferred activities: play cars, then color. That gets the child's "buy-in" to the process as a whole.  This is in essence teaching the backbone of the entire visual schedule/card system. Once the child is comfortable using the the first/then card for those activities, add in the behavior that you want to elicit. First, get dressed... Then go outside. You can even use a 3 cue system of First, Then, Next where the middle activity is the less preferred.  First, play with trains, then change your diaper, then go outside. It's the same concept as a reward system, but it just takes it to a visual level.
Once that works well, you can step up to choice cards and allow the child to choose the activities to put on the first/then card. And eventually you can "grow" into a visual schedule with multiple activities visible at once. But until the child understands the basics, seeing all of those pictures at once can be overwhelming and counterproductive.
Start this process before your schedule changes for summer. Introducing it into an expected routine will help your child accept it.

Even children who do not have special needs could benefit from visual schedules.  No matter the reason, if you choose to try a visual system the key is consistency and patience. It isn't going to change things overnight. But eventually you may start to notice a difference in small tasks, and hopefully in the overall mood of the day.  Once your child is comfortable relying on the visual strategy, you can make changes to the daily task and routine by changing the pictures.

Beyond the Visual System:

Visual systems may make the transition into a new routine smoother for your child, but what information do you include on the schedule?  JC recently had a difficult morning because at around 10:00 he realized that we hadn't gone anywhere yet.  Usually we are on the road to school by 7:45, but this morning he had been awake for hours and we hadn't left the house.  He started repeating, "ride Mommy car, ride Mommy car, ride Mommy car" because he couldn't wrap his mind around his place in the day since we hadn't followed our normal schedule.  I pulled out the visual schedule to show him our plan for the day:  We ate, we played trains, now its time for a snack and we are going to play with playdough.  He then understood the "new" schedule and adapted to it. 

Remember that many times, the smallest things that we take for granted (like going for a ride in the car each morning) have become engrained in our children.  Those with special needs, especially autism, may have difficulty understanding the "big picture" because they get stuck on the details. So provide those details so that they can fill in the blanks in their minds.

Now we are back to the question of what "details" to provide... what do we put on those schedules?  My goal is to ensure that my kids are receiving appropriate stimulation throughout the summer, while having fun and learning. If your children are like mine, you will hear "Mom, I'm bored" or "Mom, I don't know what to do" so many times that you will threaten household chores to the next child who utters those phrases. But remember, your child has become accustomed to a strict routine.  During school, they are told what to do and how long to do it. Without that structure, they are lost.  Use that to your advantage.  Maintain a routine throughout the summer to optimize the experiences of summer, without the boredom and constant need for guidance.  Think of yourself as the camp counselor/teacher/therapist/supermom that you are!

To get you started, HERE is a link to my Pinterest board for summer activities perfect for all ages. But don't feel like you have to schedule every moment of every day.  Having a general skeleton schedule will be just as useful and less stressful in most cases.

I also like the idea of having one fun activity planned each day for Activity Time.  This is actually my plan for the coming week.  My Pinterest Board has enough ideas to last all summer!

 

 

To see my actual weekly schedule along with links to activities click HERE

 

You can be as detailed and organized as you want.  Start a binder, make a list, or just decide what you want to do day to day.  But by "scheduling" the intent of the day, your child will know what to expect and will look forward to the day's activities.  For children who need more elaborate schedules, you can take the skeleton schedule template and add details as described above.  For older children or for those without special needs, the skeleton schedule may suffice.  Tailor the idea to the needs of your child and family.

And for that "I'm Bored" that you will inevitably hear... Try this!
Put different activities in a jar.  When your child says "I'm bored" have them pull out an activity.  It may be something fun, educational, or it may be doing chores!  The agreement is that whatever it is, they have to do it.  I put things like: Read, Write a story, Write a letter, play legos, clean your room, jump on the trampoline, etc.

Now that I have a plan for summertime fun, I feel much less panic - and I'm actually excited about making memories and enjoying the summer with both kids at home!

Autism... A Diagnosis for JC

Today We received confirmation of something that I have known in my heart for quite some time.
JC has autism.

But before you say "I'm sorry", let me tell you why I am not.  JC is a wonderfully sweet and affectionate, silly little boy who experiences the world full-force. He makes me laugh every day and I couldn't imagine a day without him. But, The world is difficult for JC. He doesn't seem to understand situational circumstances, social expectations and has difficulty communicating (which goes beyond the speech delay).  This adds up to a challenging world. He goes though each day with such frustration from feeling misunderstood and attacked and I feel so helpless. Every day I feel like I am failing him because I can't make it all better. He is overwhelmed much of the time and seems held back by issues beyond his control. Now we know why. Now we know the reason behind the behavior, which at times seemed unexplainable. And now, we can help him navigate through this world which consumes him.

Don't get me wrong... It breaks my heart that he faces these challenges.  As a mother, I want to remove these obstacles from his path.  But I'm happy that we have received an early diagnosis and early intervention.  And I feel validated in the decisions and sacrifices that we have made up to this point to focus on his development and to push for early evaluation. I truly expect that he will continue to respond well to therapy and will eventually learn to adapt to his world.

So while I wish things were different for him... I am not sorry that we have uncovered what lies at the root of his issues. I feel like we have reached the top of a mountain, only to realize there is an even larger mountain ahead of us.  But we have seen mountains before, and we will conquer this one too.

(I will write more about the actual testing and results later. My brain is mush right now from processing everything. )

Perspectives of a Big Brother to a Special Needs Child

JC is a lucky child because he has the most wonderful big brother imaginable. BB is 7 and is the most kind-hearted, fun-loving, sweet child I have ever known (yep, mommy bias). But I realize that God had a plan when he sent JC to our family. He knew that even though it would be difficult at times, and even though my patience wears thin, BB is always there to make JC laugh. He understands that JC has a difficult time with daily life sometimes and he tries so hard to be a guide through the rough spots. He mimics my actions and words "First put your shoes on Bubba, then you can go outside".  He is selfless in his giving and sharing because he knows that JC doesn't yet understand fully the art of social give and take. And he thinks of his own ideas for therapy for JC.  He does all of this without my guidance most of the time.  It seems to be intuitive. He just "gets it" and JC is lucky to have such a wonderful big brother.

But, I often wonder how difficult this must be on BB. I know its hard on me and on our family, but from the perspective of a child, what impact is it having?

"Mom, I'm glad I go to school all day so I don't have to be here to listen to Bubba scream all day"

"I never had therapy, because I wasn't bad, right?"

"Was I a lot smarter than Bubba when I was his age?"

These are all things that BB has said over the past few months. Each time, I was heartbroken by the reality of what BB must be feeling. It paints a picture of what his perspective must be. JC is an unruly child who misbehaves and isn't smart because he can't speak well, he doesn't know colors or numbers and won't sit still to read a book.  Of course I explain that JC just learns differently or just has problems with speech, but that doesn't mean he isn't smart. I explain that he doesn't go to therapy because he is "bad" but because he needs extra help with how he understands the world. And the screaming, well... That's something that we all just have to be patient with while helping him find the words to use instead.

Beyond that perspective, the past 2 years have been difficult on our family as a whole. My cancer diagnosis threw everything into survival mode... We just had to make it from one day to the next. Everything was so unstable and there was no such thing as routine.  Is no surprise that JC's symptoms peaked during that time. So once, I was healthy again, the focus turned to JC.  We needed to help him meet developmental goals and settle his anxiety level a bit. I always thought BB handled everything so well that we didn't need to worry about him. He is a "go with the flow" kind of kid, but what happens when that flow turns into a tidal pool and he is caught in the middle.  The anxiety level of our household is through the roof because of the stress of JC's daily issues. It affects, all of us, but I hate to say that I didn't realize the effects it was having on BB until recently.

BB was required to be more mature than most to cope with what we went through. Now he he seems to feel expected to be the responsible child, even beyond his years. He seems to inherently understand that JC has certain needs and tries not to take it personally when JC screams at him, or when I am overwhelmed by the situation. But the look on his face when he is trying to help or play and JC reacts in such a volatile way, breaks my heart. I can explain it away as much as possible, but it still doesn't change the fact that it hurts him or that it increases his anxiety level just like it does for me. Click HERE to see what I mean.

BB doesn't have friends over very often because of JC's outbursts. He most recent experience with a friend visiting involved JC yelling at this poor child because he sat in the seat that JC had apparently claimed as his own for all time. And how do you explain to another 7 year old who isn't used to having a special needs brother?  What has become second nature to BB seems uncomfortable and intrusive for other children. So he is relegated to play dates of outside or away from home. It isn't fair, and it isn't easy... but he takes it like a trooper and he never complains. He enjoys the good times when JC is being silly or wrestling with him, and he tries to lift our moods on the bad days. Which is why he is the perfect big brother for JC. He will grow up with a wealth of understanding and compassion and will be better for the experience. But for now, we all learn from day to day hoping that the day will come when we can live a life without turmoil.

Visual Strategies: Visual Schedules, Choice Cards & First/Then cards

What are Visual Strategies?

Visual strategies can consist of visual schedules, choice cards, first/then cards or any other visual tool used to help in the planning, organizing, remembering or completing tasks.  It may consist of pictures for younger children or those who are illiterate or it may be words or lists for older children. The use of visual cues helps to organize the task or daily activities making the expectations clear and understandable. This reduces anxiety and alleviates mental stress.

Why are Visual Schedules, Choice cards, and First/Then cards so important?

Visual Schedules, Choice Cards, First/Then cards are all "tools" that I rely on very heavily.  For JC, understanding verbal instructions or grasping auditory information in the mix of an overstimulating environment is very difficult.  It takes him longer to process information that he hears than that which he sees for a variety of reasons, many of which I don't fully understand (yet).

Primarily, it seems that his mind works more visually. He cues into words and seems to need a visual image of that word to process it. In the case of verbal language, if his brain takes a word and then creates a corresponding image before processing the word, then it makes sense that the processing time would be longer.  A perfect example of this is food choice.  If I ask JC, "what do you want to eat?" there is never a response. It is too much for his brain to process.  For us, it's a simple question.  But for JC, the search through his memory for all the food choices and then the process of labeling each one with a word is just too many steps.  Now if I ask, "do you want a banana or toast" that CHOICE makes it a little easier, but often there is still no response until I use a visual cue showing a picture of a banana and a picture of toast.  Then (and only then) will he make a choice by pointing to the picture.  It's like having a multiple choice test.  Choosing an answer from 4 given choices is easier than answering with an essay from memory. This is why Choice Cards are so helpful for JC.  And because it takes his brain takes longer and uses more energy to process those simple tasks that we take for granted, he is overwhelmed more easily and has mental fatigue after simple tasks.  His daily activities leave him feeling the way I used to feel after a long day at work working with a budgeting committee to iron out corporate budgets.  It's mentally exhausting.  Using the visual cues to alleviate that demand on his brain for these simple tasks frees up that energy to be used elsewhere throughout the day which means his overall mood and emotional/mental state is much better.

Think about why we make "To Do" lists.  I often have so many things floating around in my mind that I start to get anxious that I'm not going to finish then all. So I make a list. This helps to organize my thoughts and provides a visual system which I can refer to and "check off" when complete.

Also consider the power of visual cues.  When we eat at a restaurant, they put pictures on the menu for a reason... Because it is powerful.  I am a lover of Pinterest, the ultimate visual choice board. We would never read all of those articles in activities for children and recipes or cleaning tips.  But with a pictures, suddenly it all becomes easy to process. We are all visual by nature, but some are even more so.
Click HERE to watch this in action!

Visual Schedules:

We rely on the visual cues for many aspects of daily life, not just food choices.  I have 3 different "schedules" that I use daily: morning, afternoon and evening. I adjust the schedule according to our daily plans, and seeing that schedule gives jc an understanding of what the expectations are for that period.
Morning: eat, diaper change, get dressed, go in the car, go to school
Afternoon: eat lunch, diaper change, nap, table/work times, choice time (where JC chooses activities to do)
Evening: eat, play outside, bath, get dressed, book, bedtime

JC understands how this works and if we are having a difficult time in the mornings, I can rely on the schedule to say "look, we ate, now we need to get dressed so that we can go to school". It is amazing what a difference those visual cues make in that simple conversation.

I also have schedules for specific routines like bath time and teeth brushing. JC hates to wash his hair and face. It is has always been a battle.  But with the bath time routine schedule, the pictures show: clothes off, get in tub, wash body, wash hair, dry with towel, all done.  The very first time I used that routine/schedule, JC washed his hair.... Simply because the picture told him too. His visual processing is very strong, and he relies heavily on it so I am learning to use that to my advantage.

Choice Cards:

We use choice cards to allow JC to have some control over his activities.  I can choose some predetermined activities or foods and he can choose what he wants.  It also helps lot limit the endless choices which can sometimes become overwhelming. JC has a difficulty focusing on a take for an extended period. And transitions are also difficult. The choice cards are useful in both of these situations. Imagine being surrounded by a room full of toys and activities and being told to choose only 1. For JC, this is difficult. So allowing him to choose from a few choices with visual pictures makes this choice easier. I also often allow him to choose 2 or 3 activities and we work on transitions. First we do activity 1, he may loose interest flutter around the room after only a minute and at that point I refer to the visual cues and say "you choose cars, are you all done with cars". When he replies "all done cars" we move on to the next activity on his card (which he choose). This models appropriate transitioning and focusing. He cannot move from one activity until he is finished with it, and if he chooses to do an activity, he must follow through with it. It also helps reinforce the importance and adherence to the visual schedule structure.

First /Then cards:

This is my favorite :)  This allows me to direct behavior that I want by using the a goal system. First put shoes on... Then go outside.  First eat, Then you can have a cookie. It works amazingly well!  So well in fact, that I have been able to forgo the pictures in many cases and just use the verbiage: "First... then..." And he understands the directions verbally.  We are making progress!

How do I create a visual system?

There are loads of ways to create a system, and its all about what will work for your child. I like using laminated cards with Velcro tabs which make It easy to customize for the day or activity or need. Magnets work well too but Velcro I less expensive and more portable. I keep all of my pictures and cards in a folder with different sections for food, activities, schedules etc.  For more ideas you can visit my Pinterest page for more ideas:  http://pinterest.com/JCsSPDMommy/

How do I start implementing this visual system?

I started with the First /Then cards. It is only 2 pictures, it isn't overwhelming for the child and it supports behaviors that you need to encourage.
Start with 2 preferred activities: play cars, then color. That gets the child's "buy-in" to the process as a whole.  This is in essence teaching the backbone of the entire visual schedule/card system. Once the child is comfortable using the the first/then card for those activities, add in the behavior that you want to elicit. First, get dressed... Then go outside. You can even use a 3 cue system of First, Then, Next where the middle activity is the less preferred.  First, play with trains, then change your diaper, then go outside. It's the same concept as a reward system, but it just takes it to a visual level.
Once that works well, you can step up to choice cards and allow the child to choose the activities to put on the first/then card. And eventually you can "grow" into a visual schedule with multiple activities visible at once. But until the child understands the basics, seeing all of those pictures at once can be overwhelming and counterproductive.


Even children who do not have SPD could benefit from visual schedules.  No matter the reason, if you choose to try a visual system the key is consistency and patience. It isn't going to change things overnight. But eventually you may start to notice a difference in small tasks, and hopefully in the overall mood of the day.

Messy Play Day

Messy Play with Shaving Cream. Less than a year ago, JC wouldn't even touch it. He now squishes it around eagerly ... For a short time. 

10 Ways we are Breaking all of the Rules, and Loving it!

How many times were we told as children: "Clean your plate", "Don't talk with your mouth full", "Don't play with your food"?  I'm not saying that our mothers, and those generations of mothers before us, we're wrong. But sometimes rules are made to be broken.  And when you are a mother of a child who has sensory processing disorder, often those rules are thrown out the window altogether. But that isn't necessarily a bad thing, and it doesn't mean that the children are running wild with no discipline at all. It simply means that the "rules" aren't as important as the development of the child.

Here are some ways that we are breaking all of the rules, and loving it:

1.  Don't play with your food:  A huge part of JC's therapy for tactile aversion is messy play and we often use food for this. If he can't stand to touch applesauce, he will never eat it!  So desensitizing him to the feel of those textures is an important way to pave the path for him to eventually explore them with his mouth. Creating a fun activity with those items that he avoids reduces the anxiety that he feels and will hopefully allow him to associate food with fun rather than pain, angst and fear.

2. Clean your plate:  When a child has anxiety related to food, adding to that anxiety by forcing them to eat is going to be counter-productive. I have even found that limiting the amount of food that I put on JC's plate helps this anxiety level a great deal. If he has more than a few bites on his plate at once, it seems too overwhelming and he will push the plate away and refuse to eat altogether.  Likewise, if there is more than one type of food on his plate, its harder to get him to eat anything at all.  So I try using separate bowls so that he can focus on one item at a time.  It also helps that he knows he can push one bowl away and still have the other to eat from.  I also only put a small amount out at first. If he starts to eat it, he will usually ASK for more which gives him a more proactive role in the meal-time process.

3. No dessert until AFTER you clean your plate:  Let's face it, if JC hasn't eaten in 2 days and he asks for a cookie, I'm going to give it to him. With his food allergies, there are very few "treats" that he can have but he can have Oreos. I have found that ANY form of eating usually leads to more eating so I will allow the cookie on occasion to break down that wall of resistance to food.  After all, the anxiety and aversion isn't because he isn't hungry, or because he is being difficult. It's because during those periods he simply cannot stand the thought of putting food in his mouth. If we get be done that, the result is eating... No matter what it is that he is eating.  And sometimes I will add a cookie to his dinner plate with a banana or a bit of chicken. Seeing the cookie helps him to not reject the plate immediately.

4.  He is too old for a bottle:  Well, ok. Maybe he is.  My older son was bottle-free at a year old and JC is 28 months old now.  Am I just too lenient?  Am I loosing my touch as a mom?  Have simply decided that at this point, pushing JC to give up the only source of nutrients that keeps him healthy and thriving would do more harm than good. Maybe I'm wrong, but with all that he has been through, having a bottle is the least of my worries.  And yes, I have tried to transition to a sippy cup. He seems to have difficulty in drinking from a sippy (oral motor skills problem) and often ends up choking are spitting/drooling the liquid out of his mouth.  And remember, we are talking about a child who hates to have certain textures in his mouth. A hard rubbery sippy cup spout seems to be one of those textures. I should also note that JC never used a pacifier. The bottle also gives him that oral stimulation of sucking that many children with SPD continue to need beyond infancy.  Ok, enough about food...

5.   Don't climb on the furniture:  Movement and climbing I a necessity for many children with SPD (see JC's Extra-Special Needs ). So how do you encourage that movement when its 40 degrees outside or raining?  Furniture jungle gym!  Yes, there are limits.  JC would love to climb up the stairs on the outside of the railing like a  monkey if I would let him. But what I can do is provide a structured play area where he can get this type of physical activity. Today we used an ottoman and chair and JC climbed from one to the other and then jumped off into my arms. We also sometimes create a maze of bar stools for him to climb under and through.  Bottom line:  climbing is good, as long as it is safe and supervised.

6.  Don't climb UP the slide, use the stairs:  Climbing up the slide is one of the most available and effective activities at providing a workout in balance, heavy work, and proprioceptive input. We have a rope hanging over the slide outside of this very purpose. JC loves to walk up the slide while pulling himself up with the rope.  Again, as long he is supervised and safe, I encourage that activity as often as possible.

7.  Don't talk with your mouth full:  Granted, this rule exists for the benefit of the onlooker more than for the child, but for a child like JC who exhibits problems with eating AND speech I will never squash either activity - even if they happen at the same time.

8.  Don't give gum to young children:  I realize this is a safety concern, and as I have already mentioned, this activity also needs supervision. For children with problems related to oral motor skills, chewing gum is a great way to strengthen those muscles.  It also provides that oral sensory input that many crave.

9.  You should not co-sleep with your children:  At some point, after months of sleepless nights, I decided that forcing my infant to sleep in a separate room wasn't worth the agony that it was causing for him and for me. That was 6 years ago when BB (my oldest) was an infant. It was a survival mechanism.  I was exhausted from getting up 5 times a night to soothe him and I refused to use the "cry it out method".  At that point I knew nothing of SPD, but I think he would have benefited from a weighted blanket.  But once we started co-sleeping, we both were much happier.  So when JC was born I vowed not to even fight the battle of sleeping apart.  As I have mentioned, JC was a miserable infant.  He cried most of the time and nursed constantly.  He had severe reflux and spit up most of what he at so he was hungry an hour later.  There was no way that I was going to get up every hour to feed him!  So, he slept with me. It was the only time that he seemed at ease.  He is now 2 and still sleeps with me.  Our bedtime routine is a soothing, enjoyable experience unlike the hours of struggle that I put myself through with BB.  Bedtime became a time that we both dreaded.  Co-sleeping is a personal decision.  I'm not saying that every person should do it and if your child is happy sleeping in another room - great. But I wish there wasn't such judgement placed on those of us who do.  It is in fact very natural.  I recently read about  study that looked at various cultures and their sleeping methods.  They found that children in those cultures that accepted co-sleeping were much less anxious and were more secure in their emotional attachments.  (Read the article HERE - its a great read!) For a child like JC who struggles with anxiety - co-sleeping may help to soothe him and provide that attachment that he knows is always there.  Plus, some SPD children crave the pressure of weight or feeling of touch on then while the sleep - JC is definitely one of these.

10.  Don't coddle that child!:  This one probably sends my blood boiling more than any of the others. JC doesn't have a behavior problem. I am not coddling him by "giving in" to his needs. I am creating an environment that is suitable for him to feel safe and comfortable. When your child has special needs, you see the world through their eyes.  I walk into a situation and immediately evaluate what he may have difficulties with and try to avoid or accommodate his needs. Are the lights too bright? Maybe we can sit somewhere else.  Is the crowd too loud? Maybe we can use headphones.  Is there too much stimulation for him to focus and listen to me? Maybe I can provide an activity that channels his focus so that he doesn't become overwhelmed.   If he is overstimulated and needs to bury his head in my neck and have some mommy snuggles, then I am happy to provide that safe place for him to feel at ease.  Trying to get him to go outside of his comfort zone may be necessary in some situations, but at 2 years old he doesn't understand that. So it is important to him that I am there to help him cope and adapt, not just change his behavior.

Breaking the rules is working for us. And we are creating our own rules along the way.

Messy play: Tactile Aversion Therapy

Nothing shows Tactile Aversion and Defensiveness quite like messy play.  Notice the 2-finger pincher grasp, the hesitation to touch anything but the powder and the immediate "escape" response when the applesauce touches his fingers.  What the video doesn't show is the coaxing that occurred before he would even sit at the table with the food.  He has become accustomed to this type of messy play and is usually able to participate for a few minutes, but knowing that he can say "all done" and have his hands wiped is a very important aspect of the "trust" that he feels which allows him to do this.