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.