July 1, 2015
I work with a student who is a runner and has low cognition.
I find it hard to keep him safe. He seems too cognitively
impaired for picture exchange and he can run very quickly
and will drop to the floor where you can't pick him up,
he is too heavy. I am trying to keep everyone safe. Do
you have any ideas?
A: I suggest you revisit your use of the visual
schedule. Regardless of his perceived ability level, the
team should begin by focusing on creating a system
to teach him the order of events (what do I have to do,
how much do I have to do and what comes next) thereby
decreasing his stress over not truly understanding expectations.
Teach him to be confident and comfortable with transitions
by using the schedule system to communicate these basic
thinking about your student falling to the ground during
a transition, think about the whole fight or flight response.
Now add a "fort" or escape response (fight,
flight or escape). If someone is frustrated or stressed
out by a situation and does not have effective communication
skills to negotiate it, that person is likely to re-gain
control by hitting out, running away or shutting down.
Dropping to the floor is often a form of shutting down
and if you think about it, it is more adaptive and preferable
than hitting you or running away, so I would work positively
with the falling to the floor. Take the fall as a communication
effort and validate it. Avoid pushing through his resistance
because you can actually push him to use a fight response.
way to begin teaching the schedule is to have a schedule
posted (using pictures and words) of the main transition
events during the day (circle time, recess, snack time,
work time, music, etc. anything that requires him to move).
Using Velcro, have a picture representing each event next
to its' mention on the schedule and a blank piece of Velcro
next to the picture. Walk the child to the schedule saying
"check schedule" while putting a laminated ?
in his hand (with Velcro on the back). Guide him to the
posted schedule with the least amount of physical guidance
and with no words (except the initial "check schedule").
When you get to the schedule, hand over hand guide him
silently towards to first picture on the schedule; help
him put his ? next to the picture and then take the picture
off. You can then say, "time for circle" and
slowly guide him (and his picture) to the area of the
room used for circle time. Have a receptacle (a strip
of Velcro, a bucket, etc) for him to put the picture in
prior to taking his seat.
the group is over, hand him another ? and guide him to
his posted schedule (with only a "check your schedule").
Repeat the same routine using the second picture on the
schedule. Eventually, you will be able to give him a ?
and he will independently go to his posted schedule to
see what is next. This type of schedule has been used
successfully with non-verbal 2 and 3 year olds, as well
as older students who do not know how to follow a schedule.
you use a visual schedule, and you clearly teach what
is coming next, and he is still falling to the floor,
think about the other reasons for the response. Obviously
he does not want to go any further. Is he responding to
panic? Are you going to the restroom and that last time
a toilet flushed automatically and it scared him? Are
you going to the library and the last visit the fire alarm
went off? Are you going to the cafeteria and he either
doesn't know what is on the menu or he doesn't like the
choices? Assume there is a reason and the person needs
more support to make the transition successfully.
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