top of page
  • Amy Langerman

STOP MAKING ME LOOK AT YOU!

How many times has your child's school OT proposed a goal that "Billy will look at teacher 80% of the time" or "Billy will attend to whole group instruction 80% of the time" or, the one I heard about today, "Billy will sustain his engagement to whole group instruction 80% of the time". Well, next time your child's OT seeks such a goal, ask her this: "What is the standard for all of the non-disabled children in the class?"

The truth is that both children with special needs and those without can "space out" but rarely do you hear teachers mandating that students "attend" or look "engaged" unless they have a disability. And, for student's on the spectrum, research is clear that they can look like they are not attending and, yet, be attending just fine, so any goal that is measured by the artificial and (in my opinion) unreasonable requirement that they actually look AT the teacher is not only objectively unmeasureable, it is discriminatory.

So, what to do about the child who IS in lala land (and I don't mean singing and dancing ala Emma Stone and Ryan Gosling) and it IS impeding their ability to learn and acquire new information. Fundamentally, when the OT brings the goal to MEASURE (whatever they think they want to measure), the bigger question is "how are you going to teach this child to attend?" Having a goal to "attend" is useless if you aren't going to teach the child HOW to attend (assuming the goal was appropriate.)

So, the first question is to look at how to teach attention. If the child is literally jumping out of his seat every 5 seconds and unable to participate in instruction, has the behavior team come in and created an "attention" goal with small targets to be implemented with an errorless teaching ABA type program? That is one way to teach attention. The goal might start off that "after providing clear expectations of the number of problems/tasks to complete at Student's mastery level, orally and in writing, and with the use of a token economy, Student will complete the number of problems/tasks assigned without jumping out of his seat on 5/5 trials". So, you are not trying to teach attention with new substantive skills but with mastered skills. If the child is demonstrating the ability to add and subtract single digits so their annual goal is to add and subtract double digits, you might implement the attention goal with single digit math. The child will be told the expectation and the reward. "If you do one problem WITHOUT GETTING OUT OF YOUR SEAT (if that is the behavior to extinguish) you get one token (or marble or whatever). The amount of tokens to earn a reward is based on the child's then ability level. Some may need a reward after EACH problem. Others may be able to defer a reward with a token that can accumulate to a reward. The point is to use standard ABA principles to learn to attend. Once the child can do single problems, 5/5 times, without jumping up, you change the demand. Do two problems without jumping to get the token/reward and on and on. This was done with a student with whom I was working and he learned to attend and participate in independent work station programming for 45 minutes, built up from small, sustained attention, one problem at a time.

Most OTs say "well, its sensory". So, their answer is to give the student a fidgit. What then does that look like? The student stims on the fidget and, of course, he or she is not attending. So, they argue that student needs a pro-active sensory diet. So, they will give the student a 5 minute break every 30 minutes that is supposed to be sensory but often it is ipad. Why? Because they had a classwide token economy and amazingly, everyone earns the ipad exactly at 25 minutes. Even an individual pro-active schedule of sensory - taking the student every 15 minutes for 10 bounces on the mini-tramp, or two passes on the "just -right road" (the little cubicle in the back of the class with a piece of duct tape down the middle that is portrayed as the "road" to walk up and back to get movement), if the student's problem is attention and not sensory, none of that is likely going to make a material difference. And, every time you remove student for a movement/sensory break, even if it is 30 seconds, he is AWAY from instruction and not attending... AGAIN!

So, the measurement language in a goal is the proverbial tail wagging the dog. Why is the child NOT attending? Has anyone "analyzed" that question? What is the proactive and reactive strategy to prevent/respond to the behavior. In most SDC lasses, the answer is easy. Student stares off and an aide pokes them or puts an icon with a picture of two eyes in front of them. Does this help? Nope. Why would a child independently attend when all they need to do is "wait for the prompt". If behavior is telling us something - we need to know what it is telling us to teach the child a replacement behavior that works. If the function of the behavior is "escape", prompting him to attend is not the replacement behavior; you would want to teach the child to escape appropriately - e.g. Ask for a Break (which is promptly rewarded by thanking the child for asking but then saying "do one more problem and then you can have a break"). If it is independently reinforcing behavior or simply "can't help it" ADHD inattentive type staring off, then the CHILD needs to be taught how to INDEPENDENTLY self regulate because the "wait until the aide prompts you" method is pretty stigmatizing. Maybe a vibrating watch that is set for every 5 minutes to independently alert the child. When it vibrates, the child has to mark on a self-n-match form whether he was THEN attending or in lalaland. THe more times he is attending when the vibrating watch alerts him, the more points/tokens he earns. Maybe these are more distracting then the staring off but someone needs to actually evaluate and analyze the WHY - why is student not attending and is there ANYTHING that we can do to teach child to attend.

Then, writing the goal is not about looking at the teacher or appearing "engaged". You don't have to look to attend and "appearances" are often misleading. My gifted kids learned to "fake good" throughout school while being checked out because they were bored silly, reporting often that "I learned absolutely nothing again, all day". But, we should expect and hope that all children will participate as expected. So, if the teacher is doing a common core lesson and puts a problem on the docu-cam and all children are expected to take out their individual white board and solve the problem and then hold up their answer for a check, we should expect a child with a disability to participate in that activity. That is objectively measureable. The goal might be: "While participating in whole and small group instruction, Student will follow group instructions given orally on 80% of opportunities (or with no more than one prompt). You might also require that the oral instruction be PAIRED with a written instruction if that is where the Student's needs are.

What type of instructions should be followed and can then be measured? Instructions to take out your book, get a piece of paper, explain to your table mate why 2 + 2 really is 4 (a standard common core requirement!), are all oral instructions that are often included in daily lessons that a student who is not attending may miss. So, figure out how to teach attention and then measure with objectively observable actions that are reasonable to expect any child to actually complete.

Similarly, if the purpose of the goal is AUDITORY COMPREHENSION (e.g. of a lecture for a high school student), and note taking is expected, while we might provide note taking assistance (e.g. A clean copy of notes from another student or aide - like what a student with disabilities can get at college), we usually would hope to teach a student with autism or learning disabilities how to take notes to try to keep more "engaged" (even though we are not measuring the amorphous engagement.) We CAN measure note taking. So, you can have a goal that during oral lectures, and with technology (e.g a note taking app like Notability), Student will document 80% of the key ideas from the oral instruction as measured by comparing Student's notes with teacher's PowerPoint/notes. Something like that. (There are some kids where we DON"T expect notetaking - e.g. I worked with some students with dyslexia and we JUST wanted them to listen as the act of writing was SO challenging that putting it together with listening was too much - this is a determination to be made individually - can this student be taught note taking skills and will that HELP engagement or HARM engagement.) So, again, the goal needs to be objectively measureable and just "engaging" is not. The above goals are important skills for all students and are objectively measureable without having to LOOK engaged which is not required. Even my kids in Lala land could "re-alert" upon demand; when teacher put a problem on the docu-cam that they were expected to do, they could see that everyone was now working and they would look at their peers and also work. And, that is another good goal - how to "re-alert" when in Lala land or problem solve through something you THINK you can't do alone. Many kids with disabilities are learnedly helpless. They have become dependent upon some aide prompting them to do whatever. So, when you pull the aide or try to fade the aide, the student either looks for them or teacher to guide them through instead of using problem solving skills for self-help. So, the goal is "when demonstrating signs of confusion/lack of comprehension, Student will first 1) re-read available written instructions/prior examples (on board or in book) and/or 2) look at what peers are doing/ask a friend and 3) THEN try (again) to solve the problem independently before asking teacher/aide for support. Something like that - I call it the "first three THEN me" goal. This would be measured at 80% of opportunities (4/5). So, do not agree to the "engagement" goal which can't be measured anyway. Do ask "how do you intend on teaching Billy to attend". If for no other reason because it is amusing to watch their confusion trying to explain what THEY are going to do to help BEFORE trying to just measure what the child is doing in response.

Good luck.

Amy [if !supportLineBreakNewLine] [endif]

160 views0 comments
bottom of page