Leelo Rosenberg: Team Meeting Minutes: 11/15/04

 

  1. NLP: Last meeting we talked about how Leelo has been imitating 3 or fewer words, and less spontaneous language, even while his spontaneous language in home contexts is flowing.� Also, we talked about increasing the fun and spontaneity by trying NLP in other activities and environments.� Therapist L tried it while playing hide and seek in the bed, with some success. Let�s continue with this.

This week we will try the following procedure modification to emphasize the play skill goals of NLP:

�        Reduce # of words to 2 words

�        Model same phrase 2 times, paired with action w/toy

�        Pause, do action w/toy;

We are looking for �delayed imitation�- for Leelo to imitate the same phrase he had been practicing on the previous 2 trials.�� Novel, spontaneous phrases are even better.� Also, make a note if Leelo starts imitating the action with the toy.

 

  1. Reinforcement:� Supervisor M still observing that Leelo is often not motivated by his reinforcers; Let�s make a habit of offering choices every few trials (mini reinforcer assessments )- �are you working for X or Y�.�� If Leelo does not select either, then he is demonstrating the need for a different item for reinforcement, so switch toys/foods.

Also, remember to intersperse easy/mastered tasks with harder/new tasks.� The easy tasks create a responding �momentum� to keep the flow of instruction going, and may actually be a mild reinforcement as well.

 

  1. Gross Motor imitation: After playing with mirrors, verbal directions, etc, with mixed results, let�s return to a pure, imitation task.� SD= �Do this� plus model action.� Try 2 repetitions of �do this� + action, then just do action (omitting �do this�).�

 

  1. Maintenance: Previously we have been doing maintenance weekly/every other week.� Leelo readily performs most mastered tasks, except for 2 steps: gross motor imitation, play sequences, etc.� Let�s try a new system, which will create more interspersal of mastered tasks and may reduce demands on Leelo during the �cold season�.� Therapists will do about 2 maintenance areas each day (e.g. gross motor and body parts), mixed into instruction of newer tasks.� (e.g. tasks that are not yet mastered but are ready for �mixed� trials).�

 

  1. Iron Gate: Leelo continues to enjoy his mornings at Iron Gate. He has been on two �trips� (a leaf-collecting walk around the block, and a trip to the mailbox) during which he participated as nicely as his peers, staying (more or less) with his therapist, collecting leaves, putting his letter in the mailbox.� Therapist F is hard at work chosing mastered tasks to focus on for incidental instruction and practice at Iron Gate.� She will talk with Teacher K about which tasks to emphasize, and specific people and scenarios for practice.�

 

  1. Play Group:� Iz and Danielle are beginning to spontaneously adjust their own interactions with Leelo, using fewer words when he is not responsive.� On Leelo�s birthday the group made a party, and the girls took turns giving Leelo directions.� Therapist L bought Leelo a wonderful new game, Lucky Ducks, for all to enjoy.� For now, Leelo likes it best with the sound/action turned off.�� Therapist F also bought Leelo a fun Playdoh set with body parts to stick in- for certain this will come in handy in play group and during maintenance activities.

 

  1. Put on Pyjamas: Leelo should be prompted to put on his one-piece pyjamas with the zipper in the back, as this is how he manages to keep them on all night. Of course, therapists will help w/ the� zipper.� Prompt Leelo to say �Zip me, Therapist F/Therapist L�.

 

 

  1. Illness and behavior:� Leelo has had a cold/runny nose/ possible sinus infection recently.� He has had an increase in hitting himself, and had a �tantrum� at school.� As with us all, illness tends to make any difficult tasks even more challenging.� We can help Leelo when he is not feeling well by generally reducing demands (doing more preferred, mastered, easy tasks; doing fewer new, challenging tasks, spending more time in less stimulating/confusing environments).� This should reduce his use of behavior to �escape� from demands.� And, as always, prompt the appropriate alternatives (request �all done�, other requests).�

 

 

  1. Next meeting scheduled:� Dec 6 at 12:30, with guest participant Leelo�s new sibling!!

 

No Therapy Fri Nov 26

Therapist F out Fri Dec 3 (Grandma MP at Iron Gate w/Leelo?)

 

Lots of instructional modifications this meeting.� Thanks everyone for your focus.�