Saturday, January 29, 2011

Resources To Support Social Thinking (R): Expected / Unexpected Behaviors...


This is part of a series in my notes/blog dedicated to compiling a resource share file of materials to help teach Michelle Garcia Winner's Social Thinking (R) curriculum. Please share your own ideas and links in the comments boxes. These concepts can be found in the following books by Michelle Winner and at SocialThinking (R)
 http://www.socialthinking.com/

Thinking About You Thinking About Me
Think Social 
Social Behavior Mapping
Inside Out: What Makes a Person with Social Cognitive Deficits Tick?

In addition to her resources and methods, here are some useful ideas for teaching about the following concepts developed by Michelle Winner:
  • I have thoughts about you, you have thoughts about me.  The idea that people are always thinking about one another whether consciously or subconsciously.  We want others to have good thoughts about us as that affects how they regard us and treat us.
  • Expected vs. Unexpected Behaviors.  Expected behaviors are what they sound like.  Actions that are expected in a given situation such as staying seated in your desk at school, eating your food with your fork, burping quietly...  Unexpected behaviors are the opposite such as sitting under your desk, eating with your fingers or playing with your food, burping noisily with no consideration for those around you.  (These are obvious examples, the behaviors can also be more subtle).
  • "Weird" thoughts: when we commit unexpected behaviors, people form "weird" thoughts about us; not necessarily bad thoughts, nor thinking WE are weird, but uncomfortable feelings or ideas that may cause others to avoid us.
  • Good thoughts are formed when we behave appropriately.  People generally want to hang out with those they feel comfortable around
  • My actions can affect the feelings of others:  My behaviors (expected or unexpected) can have an influence on how others feel.
  • Think with our eyes:  Learning to determine what others are looking out, inferencing what their eye gaze may tell us about their thoughts, and to make "smart guesses" or predictions about their plans or intentions.
Disclaimer:  All links and pictures were found via Google searches.  Youtube clips are linked to serve as samples of the type of material available on the videos or media.  It is recommended that you purchase the video materials described and preview and note the time frames you wish to play to your clients.  If any material violates copyrights, I will happily remove it at the request of the copyright holders.  The listing of materials is for the purpose of promoting the works to those interested in using them to teach, it is not for the purpose of taking credit, stealing, or profiting from the work of others.

Appropriate age index (very general rating scale): 
(C) child ages 6-12       (T) Teen ages 13-19       (A) Adults ages 20 and up       (all) All ages

Movies / Video Clips:

Mr. Bean(all) The bizarre behaviors of Mr. Bean are caricatures of unexpected behaviors. Not only will the students be rolling in laughter at Mr. Bean's antics, but they will get an idea of how people react to his bizarre and unconventional behaviors. This helps start them thinking about how behaviors may be viewed by others and affect their desire to interact socially. Additionally, the fact that Mr. Bean rarely says anything, lots of emotion and intention are projected solely through the use of facial expressions and body language. Clips from Mr. Bean movies or episodes would also help with other aspects of the curriculum such as "using our eyes", "what's he looking at", "what's he thinking about", "making smart guesses", or "reading my plans". Youtube clips

Elf: (all) Will Ferrell's best, most suitable work. Elf is a human raised in an Elf's world. He discovers he is not an elf and starts to realize why he has been different all of his life. When he travels to the human world, he lacks the appropriate social skills to fit in there as well. However, he begins to learn and adapt. Again he represents a caricature for these kids in that his behaviors are "way out there". Youtube clips , Elf Funniest moments compilation Here is a link to PB Video Resources: Elf scenes where specific scenes are provided (great resource!).

Toy Story: (all) Clips might include scenes such as Buzz when he thinks he is a real astronaut rather than realizing he is only a toy and Woody's reaction to him. Sid, the bad boy, mistreating his toys and causing the other toys to be afraid of him. As Michelle has stated in her works, the cartoon character's large eyes work well for learning to think with our eyes.  Sid, Sid's House

                                   

Third Rock from the Sun:  (T/A) search carefully!  An old sitcom about aliens living on earth.  You will need to scan episodes to locate appropriate clips (some mature ideas) to illustrate socially unexpected behaviors.  Lots of faux pas by the alien characters due to not understanding human culture, feelings, and misunderstanding of abstract language, etc.

As our examples become less caricature-like and more typical of socially pragmatic disabled people, we need to introduce them with a bit more sensitivity, no laughter by the teacher and no sweeping remarks.  Some examples may be found below.

The Middle: (all)   Current sitcom in which the youngest child, Brick, portrays a boy who has some social pragmatic difficulties.  In one episode he is oblivious to his friends at his own birthday, preferring to read and hold his party in a library.  His friends are obviously not enjoying themselves, although Brick loves it.  In other episodes, he attends social skills classes. Brick also tends to echo the last words he says.  This character may hit a bit closer to "home" for some of the children.  Having the students observe and identify his social difficulties may help them begin to recognize some of their own issues.  Here is a fun activity that allows you to choose options and Brick will deliver a personalized greeting (just for fun).
    Super Sunday:  Brick becomes a walking encyclopedia of football facts which he shares non-stop during the Super Bowl; eventually everyone tires of the dialogue and leaves.  Good example of unexpected behaviors and how others are affected. Also would be good during the conversation lessons.
   Valentine's Day:  Not sure about the whole episode, but there is a heartwarming spot for parents when Frankie and another mom of a "quirky" child hug it out when they realize their children may actually be friends for each other. Not necessarily for the kids, but anyone working on social skills should watch this for some perspective!
   Signals:  Social skills classes.  The students are engaged briefly in conversational skills. Our social skills students could practice critiquing their class. 
   A Birthday Story:  Brick has a birthday party at the library.

Big Bang Theory: (A)  Another current sitcom.  I have only watched this a few times but several of the characters are obviously on the ASD spectrum.  Tread carefully here because they are young adult characters and the themes are often for mature audiences.  Also by using such a clip, the students may view that as an encouragement to watch the sitcom.  I would only use with an adult client.  Here is a cute episode on Apologizing that is relatively "safe".
Friendship Algorithm Depicts perspective and social skills deficits
Rock Climbing (the result to the Algorythm) Depicts anxiety issues / social deficits  (saying what he thinks to people)
Sheldon can only manage 5 friends, so needs to let one go Lots of examples of inappropriate behavior in groups
Germaphobe

Malcolm in The Middle:  (all) This link also found on PB Video Resource for Social Skills Development.
Perspective taking & literalness:  Don't play ball in the house
Size of problem vs. size of reaction:
Reese & Goat 
Mall duel

The Social Network: (T/A) Movie about Mark Zuckerberg and FaceBook.  The movie portrays him as a person with social pragrmatic difficulties.  There are several episodes where he makes unkind or unfeeling remarks.  Once again, you must choose carefully some clips as the movie itself contains material inappropriate for children and teenagers.

Strategy for reading body language, situational cues, and facial expressions and making "smart guesses" based on them:  Find a particularly animated scene from a sitcom and turn off the volume.  Have the students watch the situation silently and infer and draw conclusions as to what is happening.  Then replay the clip with volume and see how well they did.  I did this with a clip from a Cosby Show when Denise made Theo a shirt in order to save him some money; with a poor outcome. 
   Cosby Show:  A Shirt Story

Carol Burnett Show:  Charades Part 1 & Part 2  Really funny take on playing charades and people's attitudes, gestures, moods, and body language to indicate these. Warning: some bad language.

Wallace & Gromit:  Claymation cartoons mentioned in Winner's books.  Great large eyes for teaching about thinking with our eyes and making smart guesses about plans and intentions.  Wallace, the man, is a not a great social perspective taker but his dog, Gromit, is an excellent social perspective taker.  I used the cartoon The Wrong Trousers with a group and then we decided to produce our own W&G skit. There are lots of Youtube clips available.  A related cartoon is Shaun of the Sheep.

Commercials

Commercials are often very creative.  They are also nice and short and have to get the message across quickly.  Here a few that have caught my attention as possible candidates to make points about our social curriculum.

Volkswagen: The Force   In this a child in a Darth Vader costume (complete with soundtrack) tries to use the "force" to move items in his home.  Since he is covered by his costume, we can only surmise his disappointment and frustration by his body language.  His dad comes home in his  new car and as the boy tries to use the "force" one more time.  The father, behind the scene, uses his remote key to start the vehicle.  Then we witness the body language of shock.  Really cute piece!

Bing Overload Commercials  Everytime I see one of these commercials with some character spouting out fountains of info with no social connection to the conversation partner, I think of several of my ASD clients.  Great illustration of information overload, giving too much detail, and talking "at" others rather than "with" them. And the responses of the communication partners are a key part of what we want to point out:  confusion, frustration, anger..
     Breakfast, airport
     Handbag, You talking to Me?

Ally Bank with Kids:  These are priceless for the genuine facial expressions on the kids when someone does something unexpected... Check all of them out on Youtube.  The "moral" stated in the commercial is in ( ) if it might be applicable to your lesson.  But you can always extrapolate your own messages such as observing the various facial expressions, how did the kids feel, why did they feel that way, what was the unexpected behavior by the man, what would have been the expected behavior, how do we sometimes do this type of thing to our friends, or has this happened to you....
Would you like a pony?
Would you like to go for a ride on that bike? (ridiculous conditions)
Have some fun with that truck.
Do you want to play hide and seek? (wrong to leave someone hanging when they are counting on you)
Can I have some ice cream? (it's wrong to treat new friends better than old friends)
You took my eggs. (it's wrong to take other people's stuff)
Can I play with those toys? (wrong to give someone the "run around")
Behind the Scenes of making the commercials (For those concerned about these commercials... looks like everyone had lots of fun!)

Geico Commercials :
  • The Caveman commercials are classic for being sensitive to the feelings of others.  You can also play the early ones and discuss why the cavemen are offended.  Then play the later ones that are more subtle and discuss why the caveman does not want to be in a Geico commercial (plays on previously learned information or inferred information).
  • The Piggy Cried Weee depicts an annoying little pig that can be used to discuss being aware of how our behavior might impact others. 
  • The commercials with the questions man also have lots of figurative language references: Does the buck stop here?  Does a woodchuck chuck wood?  Does a drill sargent make a good therapist? (being insensitive to others).
  • Gecko often gets into awkward situations such as spending the boss' first dollar bill in the vending machine, having to catch the boss as he falls...
  • The commercials with assisted story telling are cute too. 
  • Squirrel commercials: hidden motives?
I seriously never realized how creative the Geico Ad teams must be until just now!

Allstate Insurance Mayhem: Unexpected behavior, inattention and the problems it can create, consequences of extreme emotions and why we need to control them (teenage girl episode).

Xerox commercials:  Mets commercial is good for "foot in mouth" issues.  Marriot Hotels workers show "one upmanship" and can be used in a lesson about not trying to make yourself look better than the other person.

Not a commercial, but a good short spot that shows people often have inner struggles that others cannot see.  Can be used to teach that we don't need to tell everyone every problem we have.  Also, the point of the video clip, is to teach that our behaviors or actions can have an effect on others:  we should try to be kind and friendly to others. LINK

SpeechTechie Blog posted some good suggestions regarding Shaun the Sheep and suggested subscription to Netflix in order to access many resources.

Therapist Made Resources

The following items were made with Boardmaker to add visual supports to the Social Thinking basic concepts.  (If you want to print these, open the link, right click on picture, click "save as" to a file on your computer, then you can print them.  I do not think you can make changes to the boards.  I am not sure whether or not you can import them to your own Boardmaker and make changes... if you can, please let me know and I will post how this can be done.)

4 Steps of Perspective Taking  Addresses the aspect that people have thoughts about each other.

Thinking with Eyes / Referencing Behavior Addresses how our eyes help us socially.

Hierarchy of Skills The four basic skills for successful social skills:  Thinking of others, Physical Presence, Using our eyes, and Conversation/Words.

Physical Presence The Do's and Don'ts of establishing a physical presence with a group or with others.

Thinking About Others Ideas on things we need to consider about our communication partner to assist in regulating our behavior and our words.

Unexpected Behavior Mapping Great tool to help clients understand the chain of events that can be caused by their unexpected behaviors and the negative outcomes.

Expected Behavior Mapping This charts the events of expected behaviors and the postive or at least neutral outcomes. These two boards were made to offer visual support or reminder for younger clients.  The pictures in the headings help keep them focused on the ideas to explore in each column.

I found a wonderful site by Jill Kuzma.  She has created and posted loads of great worksheets and PDFs that also supplement Michelle Garcia Winner's Social Thinking curriculum.  Plan to spend a lot of time perusing her site!  I am posting links to a few of my favorites.
Expected-Unexpected Definitions
Expected Behavior Map
Unexpected Behavior Map
Thinking and Talking Bubbles
Just Me & Thinking About You cards
Making Impressions
Brain Social Filter

Book Links

Children's books on teaching emotions  Angry, Happy, Sad, Grumpy, Silly... includes books on learning to regulate your emotions and responses.  Teaching emotional states is always important with social pragmatic challenged clients.  This teaching can be done as a stand alone objective or it can fit nicely with Social Thinking lessons that discuss how our behaviors can affect the emotions of others.  Also it is useful when discussing the problem rating scales and learning to gauge our emotional responses to match the severity of the problem.

        
 
Vocal Regulation:  Great resource to use with book Holler Loudly is a kindergarten teaching unit from Cynthia Leitich Smith (guide versions for Pre-k, first, and second grade available; click on kids books and Holler Loudly to find the Teacher Guides). This book can be used to kick off a lesson on vocal regulation.  Please check out the authors website for lots of great resources on this and her other books.  Here is a link to a worksheet  from ReadKiddoRead.com based on the 5 point scale. (This lesson might fit well with Unexpected Behavior teaching).

Wordless Books:  I have found that wordless books are great ways to teach about facial expressions and to infer meaning from context.  No words means the children must carefully use their eyes to figure out what is going on in the story and must make lots of  "smart guesses" as they try to piece together their own story.  Since kiddos with ASD are often hyperlexic, this requires them to engage their own verbal expression skills, critical thinking, inferencing, gestalt processing, and social knowledge.   

101 More Life Skills Games for Children (connect, play, create)by Bernie Badegruber.  I have been looking for small group games and activities to use in our groups.  I found this book on Amazon.com and it looks promising.  It categorizes games in sections such as "I Games (what I'm feeling), You Games(perceiving you, working with you), We Games (cooperation, relationship games)".  There is also a version for ages 6-12 which includes a section on imagination.  I just added it to my amazon.com cart for the next order.

Please HELP by adding your ideas.  Check back often as I will add ideas and edits to this blog.

You may also be interested in these related posts:
Eye Conact, Social Referencing, Joint Attention
Social Skills: Thinking & Language...
Perspective Taking

Friday, January 28, 2011

My Journey into Autism Treatment as an SLP from the Stone Ages

Someone recently asked me if I had a special interest in Autism since we are promoting programs suited to this particular population.  I paused a moment and answered honestly, "Well, I do now because children with Autism were walking through our doors and we had to figure out what to do with them."  I am not sure if I should smile or grimace as I think back to my first experiences with children on the spectrum.  I knew next to nothing, but I did the best I knew to do, which was not nearly enough. 

I went through my college programs between 1980-86.  Autism treatments were in their infancy back then.  University programs in Speech Pathology were not yet being accredited.  We had no classes on Autism; I am not sure the term even came up more than once or twice.  The closest information I studied was in Special Education classes.  (My program offered education degrees so I chose Special Education endorsements).  In these classes the terms were Childhood Schizophrenia and Minimal Brain Damage for diagnoses now called, for the most part, Autism, Learning Disabilities, and ADHD.  Instead of Ritalin for ADHD, serving coffee was recommended.  As a youth, I was intrigued by children with disabilities.  I recall reading the book Lovey by Mary McCracken about the work of a teacher of children with disabilities.  The title character was a little girl with Autism. My first personal encounter with Autism was my first year or two of working in the public schools.  A beautiful boy with dark read hair came into my speech therapy room for  an assessment.  He had limited verbal skills but he went through my box of crayons and picked up one of the few in my box that was an off-brand and he said, "Kmart"; sure enough the crayon had Kmart marked on it.  His mom explained that read labels all over the house such as "whirlpool, maytag, etc."  I was fascinated by this high functioning hyperlexic child.  Amazingly, with over 100 students on my caseload, he is the only one I can remember who actually was diagnosed with Autism.  I am sure there were many, but I think they were tucked away in the self-contained classrooms.  And with a 100 students on my caseload, I did not go looking for students who were not being referred. 

I moved from the schools into working with adults.  When I returned to pediatric work and bought a private practice, I quickly found myself facing Autism again.  Luckily I had a new young therapist with me who had more training in the area of Autism and even had learned ABA (Applied Behavioral Analysis) in her program; so I was happy for her to pick up these clients, after all, she understood them better than I did.  I watched out of the corner of my eye all the while and tried to increase my skills.  I have to admit that I was a bit afraid of these children who did not respond to the same toys and games that other children loved, who could be calm one moment and the next moment be screaming for some unknown reason, or who just sat unresponsive.  Then my dear therapist moved away and I was faced with clients with Autism who needed treatment, from me. Luckily I had attended PECS training (Picture Exchange Communication System) and found this invaluable in working with these children.  The principles of picture communication fit perfectly with the visual strengths of individuals with ASD (Autism Spectrum Disorders).  Next I started digging into information wherever I found it.   I am no expert, but each child, as different as each has been, has added to my understanding of this disorder.  I feel fairly capable with them, most of the time.  But I must admit, I still am stricken by fear when I face that child who melts down unexpectedly.  Fear that I will not be able to regain control of the situation.  Fear that I will not be able to help this particular child.  However, I am learning that there is nothing ultimately to be feared.  Sometimes things will not go well in a session.  I just need to stop and observe the situation and provide whatever comfort I can.  Sensory strategies and pictures are very helpful most of the time.  (We know so much more now about these children and we have so many more tools than ever before: thankfully).

This past year and a half I have been working on assimilating a new area of learning: Social Skills development.  Most of our ASD clients are high functioning or Aspergers.  I found that language therapy was not hitting at the heart of the difficulties these children encounter socially.  We worked on vocabulary, concept formations, expressive language skills, inferencing skills, comprehension, and processing, but something was still missing.  These kids still were not connecting socially to me and were outcasts among their peers.  Then I attended a workshop at my local service center by Michelle Garcia Winner, called Social Thinking. 

Many years ago at a state convention I had attended a workshop on Theory of Mind (TOM) as a new emerging concept. I had bought and read one of Michelle's books 2-3 years earlier but just did not quite grasp the concepts.  I had some exposure to these ideas of perspective taking.  Reading about RDI (Relationship Development) and  Greenspan's work furthered my understanding.  But listening to Michelle in that workshop, it was as if a light bulb suddenly began to glow above my head, growing brighter and brighter.  I had my "Aha" moment.  These things she was saying, these things made sense, they were the missing pieces I had been lacking. They are by no means cures, but they are methods and strategies that help the individual with social pragmatic disabilities improve their understanding of the social world and learn how to navigate through it.  Just as it is a slow process of assimilation for them to understand these ideas, digesting Michelle's insights has been and is an ongoing process for me as well.  To learn more about Social Thinking, visit http://www.socialthinking.com/home