Sbsd staff training part 1 by Circlestretch

circlestretch Help the child be… • Calm enough to interact • Truly connected to others • In a continuous expanding balanced back and forth flow of interaction “Go for that gleam in the eye!” http://www.circlestretch.blogspot.com

Connecting kids II: In-Class Examples of DIR/Floortime速 Joshua D. Feder M.D.

Faculty, Interdisciplinary Council on Developmental and Learning Disorders Assistant Clinical Professor, Department of Psychiatry University of California at San Diego School of Medicine

Alice Prince, MA (?)

RSP, Solana Santa Fe Elementary School, Del Mar, CA December 17, 2008 Solana Santa Fe Elementary School

Warning: this will go fast â&#x20AC;˘ All the slides will be posted on www.circlestretch.blogspot.com

Taking Notes? • One word:

ENGAGEMENT

• One phrase: Engagement goes beyond compliance.

Definition of Relationship Based Intervention: Relationship based intervention is the use of ongoing affective connected interaction to promote developmental progress, focusing on co-regulation, engagement, and social reciprocity. This is done in a context of a well rounded biopsychosocial understanding of the person, and carried out throughout the day by caregivers who are guided and supported as they develop growth producing relationships.

WE USE EMOTIONAL CONNECTION TO FOSTER DEVELOPMENT WE TAKE INTO ACCOUNT THE PERSONâ&#x20AC;&#x2122;S INDIVIDUAL ABILITIES AND CHALLENGES WE WORK WITH FAMLY AND OTHERS TO MAKE THIS HAPPEN ALL THE TIME

Quick Review of Functional Emotional Developmental Levels • • • • • • • • •

I – co-regulation, ability to attend II – engagement, gleam in the eye, warmth III – circles of interaction IV – flow/ behavioral organization in social problem solving V – symbolic thinking (critical to tolerating affect) VI – logical connections between ideas VII – multicausal thinking VIII – grey area thinking IX – reflective thinking, stable sense of self, and an internal standard

Solving in-class problems at various levels: Co-Regulation • Problem: LOUD voice, directed at his paper: 'I don’t how to do this..’ • Approach: make a ‘space’ for you and him • talk w/ him about it • visual cuing icons for: ‘We can figure this out’, ‘shhh’ and a 'raise your hand' • how to get him looking up and keeping others in the visual field - if all were up on stools and drafting tables…

Solving in-class problems at various levels: Engagement • Problem: distracted; no interest in guest speaker, trouble answering in class; if not feeling it he doesn’t connect (remember dual-coding?) • Approach: instead of using prompt e.g.'eyes down please' do something else to engage him in the communal moment - ‘this story is so cool’ – ‘we are getting to think about this together’ • anticipatory guidance – ‘I wonder what you think about it...’ • rule: find the fun – for each student • HISTORY CHANNEL, live • find, maybe write down, stuff the speaker wants you to think is interesting or funny

Solving in-class problems at various levels: Circles • Problem: struggling w/ joining in and communication counter-intuitive to have chit chat in class, although with class moving on had to stop at times • Approach: do it in a non-verbal manner, cuing to see what others are doing; solving problems non-verbal, engaging non-verbally • Problem: not bringing in his own ideas; sits and says he doesn't know what to • Approach: using statements - works well in getting him to express himself, better feedback when she uses statements • Result: writing independently, w/ a writer's voice, more than he has to - HUGE, HUGE, HUGE!; part is 'I thought to myself...' - thinking about thinking -

Avoiding Questions Feder’s Tip of the Century

• Questions are top-down, ‘Guess what I’m thinking’ • Questions put people on the spot, and make them more likely to get upset and close up or act mad • Statements create social ‘problems’ that the other person can ‘solve’ • Try it out. It’s hard, but worth the work.

Solving in-class problems at various levels: Flow • Progress on the playground • friends asking him to play: ’Come play with us!’ • Coaching, OT/ APE effort paying off - how to run, how to look up, etc. • arguing re the rules in sophisticated way shoulder to shoulder, hashing it out - great!

Solving in-class problems at various levels: Symbolic and Logical Thinking • Problem: math – must ‘do it right’; frustrated; takes too long • Approach: symbolic concept ‘impossible problems’ • Logic = faith in the process (Star Trek falling hammer) • Logic = self-advocacy, asking for help when appropriate

Marilee Sheet on Math Following his lead: ‘I must do it right’

Joining: ‘Of course we want to do it right’

Circles: statements that build ideas, e.g., ‘I’m not sure what makes this so hard for us.’

Set the environment: making a space (Like ER or on a date)

Expanding the concept: Impossible problems, then sorting easy, hard, & impossible.

Broadening Emotional themes: from intense reaction to stepping back, less intense, curiousity; from perseverative angst to calm perserverance

Individual Differences: reactive to busy environments, poor motor planning, trouble reading cues, trouble expressing himself including loud voice, visual figure ground difficulties, poor planning, sequencing, execution, and adaptation; perfectionistic and reactive.

Working Multiple Levels: Co-reg: space Engage: joining him Circles Flow: working problems together Symbolic: ‘impossible…’ Logic: ‘We can do this’, right = showing what info isn’t needed, right = showing your work

Critical Benefits of Symbolic Thinking • Expand his thinking so that he are not stuck in the black and white, all or nothing world • compare w/ others so he knows he isn’t doing badly • Tolerating a difficult moment with confidence that he can get through it – like being stuck in a haunted house – uncomfortable in the moment – like four square – that’s part of the fun – • it helped that day when they were explicit – not saying just fine but acknowledging that it is hard, he can be proud of it when he is done (COMPETENCE) –

How’s the tracking going? • Do we agree more on what co-regulation looks like? • Engagement? • Reciprocity?

Data Tracking Sheet Date: _____________ In Class am

Time: _________

Co-Regulation Is he calm enough and settled to attend to an interaction? Are you ‘tuning in’ to near where he is emotionally to help him join in? Examples of not regulated:stretching, distracted, staring off, eyes not on the group/activity, over/underactive for the situation

Engagement Gleam in the eye? Is he “on the same page” , paying attention to the same thing the “group” is? -eye gaze to peers and eye gaze to activity/items that the group is interacting with…visually and/or verbally referencing peers

Social Reciprocity (Circles, Flow) True Back and Forth in speaking and listening interactions -opening (initiating) and closing (ending) circles of communication verbally or nonverbally

Student: _______________ Recess

Time: ______

In Class

Time: _______

Person Recording: _________________ Lunch Time: _______

Afternoon Time: _______

School Data Tracking Sheet instructions and comments *Fill in #minutes/15 minute sample for tracking co-regulation and engagement

**Use hash marks to count number of times the child initiates or responds appropriately for social reciprocity **Complete one data sheet per week during all kinds of activities including class time, free choice, recess, and lunchtime Comments:______________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________

A General Plan for the Management of Difficult Moments * • • • • •

Have a plan ahead of time Adjust the environment Soothe Talk Anticipate

*reference:

A Bioethical Approach to Overcoming Problems with Aggression and Misbehavior in Schools, Stanley Greenspan, M.D. ICDL 12th Annual International Conference November 7-9, 20082008 ICDL Fall Conference, Washington, D.C.

Thoughts and Questions • Next meeting is 3/18/09 • Use circlestretch • Great Kids