Mrs. G Wiz

Starting a blog is in many ways simple thanks to great platforms like Blogger.  For me, the most difficult challenge, choosing a name.  I wanted one that was short enough to be remembered but also described me in some way.  My students have called me "Mrs. G" for the last 16 years or their own variations of it.  (Yes, for two years and entire school called me "Goof" but that is a story for another day.)  One of my student's families gave me the full name"Mrs. G Wiz" two years ago.  They held a special dinner to thank the teachers that worked with their children and the theme was Super Heroes.  All of us teachers arrived to discover our super hero identity.  I was named "Mrs. G Wiz" complete with a yellow cape.  As the mom lovingly read my me super hero skills, I knew...

Wiz was not for my intelligence or insight.  No, it was for my skill in...drum roll please...

Toilet Training!  

(You now see why I received a yellow cape)

Toilet training, in my experience has been the most frustrating few weeks, months, and in some cases, years for the parents and families I have worked with through the years.  The pull-up, diaper, and changing bag are the items no one wants with them everyday of their life.  Individuals with disabilities are no different.  Often, when i meet with an incoming family, their first concern is related to toilet training.  Needless to say, after 19 years I have developed a program for students in my program who still need to become independent in the bathroom.  All children are different so I have to modify it a bit for each student but there is a basic plan I begin from and it has been successful, so far.  I thought I would share it in hopes of refining it further with your experiences. 

Toilet Training Program for Children with Special Needs

Toilet training is one of the most critical elements to a student’s independence and yet, is also a frustrating thing to teach for the child and the parent/teacher.  Here is an approach that I have used with good success.  Not all children are the same so the amount of time it takes can vary but it will happen…have faith.

Things you need to know (how to find the answers is described below):

1.    What are the biggest daily motivators for the child

2.    What the child would like most to earn as a “big kid”

3.    What are the times that the child’s body needs to use the restroom usually

4.    How long can a child wait?

Biggest Motivators (Questions 1 & 2):

You probably already know what your child/student enjoys most but in this case it needs to be motivators that you can withhold until they are earned.   If the motivator is an iTouch for example but they are using one of the communication apps such as Proloquo2Go, this is not a good motivator for toilet training.  It can be as small as a high five and as big as time on the computer.  This is very personal.  You may, for some children need to provide a menu of reinforcers they can choose from if they are not consistently motivated by one thing.  Again, this needs to be a list of things you can withhold.

Time Issues (Questions 3 & 4):

To determine what time the child’s body naturally needs to use the restroom and how long they can go between visits, you need to collect data.  Don’t worry, this is very easy.  Each day, write down the times you took the child to the bathroom and whether or not they went at all.  Also, write down any time that the child goes to the bathroom in their pants.  This is far easier to be accurate if you have the child in regular pants as it is very hard to know when they have an accident in a pull-up.  However, sometimes, you have to use a pull-up.  I understand and appreciate this, it is just not my recommendation. 

After 2-3 weeks, you will see a pattern of times that you will note as naturally the time to use the restroom.  It may be a window of time but the closest you can narrow it, the easier for you in the long run.

The Plan:

Step 1:  Create Schedule for visiting the restroom using the data above.

Step 2: Find a new home for the reinforcers that only adults can reach.  This is their new “home” so you are now the one who can provide the item/time reinforcers when it is earned but also put it away when it is lost. 

Step 3:  Put a schedule of the month somewhere in or near the restroom along with stickers.  This is now the goal for the “big kid” reinforcer.  Depending on the size or cost of the reinforce, you can create an amount of stickers the child needs to earn to get it.  I usually start with 20.  The child earns a sticker for a perfect day using the restroom.  Only for a perfect day.  If the child has an accident in their pants, write a sad face on the day right away so they see that it is a sad choice.  Then proceed with the rest of the day following the rest of these steps.  Please note, if the big reinforce is getting close, you need to make sure you can honor it within 48 hours of the child earning it.  For instance, 20 stickers=a trip to a restaurant.  You need to go once the child earns it, even if they have made other poor choices as they DID earn this one.  It is most powerful if they can only get the reinforcer when they earn it but I understand that birthday parties, family get-togethers, play groups may choose the same thing.  That is okay, just make sure when the child earns it to restate that to them throughout the time you are there.

Step 4:  Assume success.  If the daily reinforcer is access to a computer, tv, or other electronic device, a toy, room, or materials like markers or crayons,  they should have it until they lose it.  Again, only use reinforcers that are not also communication devices.  If it is a piece of candy, sticker, marshmallow, high five, etc., they only earn that once they use the toilet successfully.

Step 5:  Take the child to the bathroom.  Upon entering, review the calendar and what they are trying to earn.  For example: “Look, you can go to Red Robin if you earn 20 stickers.  Here are the stickers you need to earn.  You have to go in the potty all day to get your sticker.  Boys/Girls who go potty in their pants do not get Red Robin (make a sad face).  Boys/Girls who go potty in the toilet can earn Red Robin (make a happy face).  Let’s see if you can use the potty.”

Step 6:  Try to be as quiet and inconspicuous as possible while the child is on the toilet.  Most children will try to engage the adult through talking, pointing to things, trying to play but if you can, ignore as much as possible so the child gets the message that on the toilet, they have job to concentrate on.  Wait 3-5 minutes (longer if the child has Cerebral Palsy as they need time for their body to listen and react). 

Step 7:  No luck.  Remind the child about their “big kid” reward on the way out and that they need to be big and keep their pants clean and dry.

Step 8:  The child uses the toilet—HOORAY!   This is big, make it a big deal.  For example, I am famous for my “Potty dance.”  If the child has a daily reinforce such as candy, stickers, high five, etc.  get it to them immediately.  If it is an access reinforce such as computer, TV, etc.  Tell them, “You can go play ______ because you were so big and went potty in the toilet.”

Step 9:  The Accident.  Yep, they will still have some accidents.  At the moment of the accident, they have now lost any access reinforce such as computer, TV, etc.  Tell them so but briefly and concisely.  Example, “So sad.  You peed in your pants so no more computer.   I am putting it away.”  Then go right to the restroom.  To the extent possible, the child needs to undress and dress themselves.  They also should sit on the toilet for a minute or two.  Some children will then go again.  Just remind them that they peed/pooped in their pants first so that is sad.  Also, write a sad face on the “big kid” calendar.

Step 10:  Get right back on schedule.  The next time the child visits the restroom dry and clean AND uses the toilet, they get back any access reinforce or daily reinforce.  The idea is, when you are big, you get big stuff.  When you are not, you don’t.

Step 11:  Accidents while sleeping, one extended car or plane trips, or extended bus trips such as field trips do not count against the child.  In fact, these are the times I support the use of a pull-up as the child has no control of the situation.

Step 12:  Tomorrow is another day.  Each day, start fresh.  At the beginning, you may have accidents every day but the time of the accidents will get alter and later until they disappear.

Some of my favorite daily reinforcers:

Access to movies and/or TV

Computer access

Access to a trampoline/back yard

Access to marker instead of only crayons

High fives

A song and dance together

Juice instead of water

Getting to be first in line, at games, etc.

Small food items if the child is only motivated by edible things

Some of my favorite “big kid” reinforcers:

Going to buy “Big kid” underwear together that is fun designs

Baskin Robbins or another frozen treat

A lunch date to Subway –as a teacher, taking the kiddo to lunch is VERY powerful and motivating

A trip to the local indoor pool

A movie at the theater or a 3D movie

A trip to a favorite activity place such as indoor jumping, a favorite kid-friendly restaurant that includes video games or things we can do together, bowling, swimming, a museum.  (For one student, going to see the dinosaurs at the museum was worth 50 days meeting his goal!)

Good luck, have patience, and believe that anything is possible.  IT IS!!!

 

Tr*ns!t!@n!!!!

“Transition” is the word that I have often heard said as an explicative as well as through tears. It is a simple word really.

 Transition: noun --the process or a period of changing from one state or condition to another.

However, “transitioning” is not so simple.  A parent of any child worries from the minute they first hold that small miracle until, well, forever.  This is true for all parents.  But when they child’s still being alive is a miracle, when the worries are about tube feedings, immune deficiencies, upcoming surgeries, and seemingly insurmountable communication delays, the worries are magnified. 

How can the next school or teacher possibly know everything they need to know for my child?  Will they learn how to use their communication device?  How to tell the difference between the in pain cry and the tired and sick cry?  Will they know how important it is that they get 10 minutes of sensory input before being asked to sit?  Will the teacher or school communicate with me?  How will they?  Will I know what my child is doing during the day?   How will I know if my child is getting their needs met?   Will the IEP be followed or changed?

This cycle of questioning starts at the beginning of the year of transition and continues until the next year and into the fall.  The teachers such as myself ask very similar questions as we are also attached to the child we have taught, laughed with, calmed, cried with, and loved.  Knowing the professionals at the next site always makes it easier as the questions are answered, and yet, for me at least, I still know that my class will change.  Each child brings their own personality and those personalities combine to create that class. 

As I prepare for the changes, the families, students, and next school or teacher are also preparing.  I watch the families I have spent hours and many emails talking to struggle and wish that I could ease their fears.  What I have learned is, the professionals receiving the child are all good and wonderful people with various levels of experience and various philosophies but they are good people.  They will love the child as I have, but in their own way.  The thing that the parents and I can do is make certain the current setting a welcome place for visiting and collaborating.

I recently had an Eligibility (Triennial) IEP for a student who I have been fortunate enough to work with for the past 6 and ¾ years.  The special education teacher and speech pathologist for the middle school came to the meeting.  Additionally the teacher and I had collaborated on ideas for the goals prior to the meeting.  We were a team and so, the transition was in some ways, already completed.  It was a small step but it gave everyone who has worked with this student this year the chance to ask questions, think trough possible concerns, and, most importantly, begin talking to each other.

Did this stop the parents’ questions?  Of course not! Their child hasn’t stopped growing, changing, trying new things.  There will always be questions, but at least now they have someone to ask for answers.  It is a small thing, but something.

In the end though, I am still going to cry after the last day of school.  Tears of joy.  Tears of hope.  And selfish tears that I will not have this student with me each day.

Spring Fever

Spring is here and for teachers this means increases in chatter, student distractions, planning placements for next year, transitions (that is a post of its own), and...

Hormones!

The Scream by Edvard Munch

Tiny little chemical messengers within the bodies of these small children have now created chaos and interesting changes to our classroom.  No longer can the kids in the “clubhouse” be a co-ed group.  Googly-eyed stares, blushing cheeks, and frequent visits to check the mirror have taken over.  

How is it that warm weather can create this?  Do the hormones build and travel faster when the sun warms the body?  Does the increased vitamin D from the sun make the hormones go crazy?  Somebody, please tell me.  Also, can I counteract these effects if I keep the classroom at 60 degrees or less?  I’ll wear a sweater and coat all day if it can keep these small little children from becoming teenagers too quickly.  Really, I will!

Lost Kids!?!

The goal I have for all my students is that they are “lost” in a group of their peers.  No, don’t panic!  I don’t actually want to lose them.  What I am talking about is the moment that their social skills, behaviors, and actions are so age appropriate that you no longer see:

child… child… student with a disability… child

or worse yet:

child…child…    ….   ….   … student with a disability and para

I am referring to the moment that the student is a peer, a friend, a playmate.  It is the greatest moment for me as a special education teacher.  But it has also caused moments of panic as the paraprofessional, teacher, or parent suddenly couldn’t find the student.  For a brief moment, the fear that they are lost over takes our heart.  The next minute, we realize that our every hope for that child is met, at least for the moment. 

This past weekend was an example of that.  Some of my students went to a Special Olympics basketball tournament.  I was home sick in bed and missed it but a parent kept me in the loop through texting and these photos.  It was then that I saw that “lost” moment.  All the kids are playing well.  You can’t tell who has the disability and who is the peer partner.   

You only see kids, playing basketball, and winning second place.  (Okay, that was just bragging but after all, they are my kids, I should get to brag.)

Yes, last weekend, my kids were “lost” and it was a great victory!

What is that?

Periodically I am asked by a general education teacher to talk to their class about disabilities or a specific disability.  I always enjoy these opportunities as I get to hear what the students are wondering and the ways that they develop an understanding and compassion.  Last Friday was one of those days.

I have a young man in a primary grade with Down Syndrome.    He is a charismatic, funny, adorable young man who is also popular.  As he grows older, his peers wonder why.  Why does he talk different?  Why is he so short?   Will he grow?  Why doesn't he read and write well when he works so hard?

The teacher and I talked about a variety of messages we wanted to teach to the students but we both agreed that they needed to learn about what Down Syndrome is and what it isn't.  The teacher set the stage by talking to the class about how to be a friend even when you are not alike.  Then, I met with the class the following day to explain Down Syndrome.  I am always nervous.  Will I make it sound scary or confusing?  Will the students have more questions and concerns when I leave than when I came?  What questions will the ask that I don't know how to answer in a way that a 7 or 8 year old can understand?

 http://www.cdadc.com/ds/

I decided that I would talk about chromosomes.  First I talked about how there are little, teeny, tiny parts of the body that decided if you will be a boy or girl?  Blonde, brunette, or red-head?  Tall or short? I told them they are called chromosomes but the most special thing about them is that they are all twins.  Then I drew little sticks that were "holding hands" with their twin.  That set the stage to tell them about what makes people who have Down Syndrome so amazing.  They have a set of triplets at the 21st row.  The students thought this was amazing and found it to be a great explanation.  We then talked about the messages those triplets gave about being a little smaller, having shorter fingers, a flatter nose, and a larger tongue.

The class and teacher then participated in an experiment to find to what it was like to have Down Syndrome with a larger tongue.  I found this idea at another great bloggers site http://elliesgift.blogspot.com.  You simply get the large marshmallows and cut them in half.  The students, teachers, or anyone else who wishes to participate pushes the marshmallow onto the roof of their mouth and then tries to talk.  Instantly the participant has a Down Syndrome accent.  It is a simple but dramatic experiment and helps others to understand the struggle that individuals with Down Syndrome have to even talk to a friend or family member.

We talked as a group about how frustrating it was to try to talk.  Then I talked about how I don't know if I would keep trying if it was that frustrating but that the young man with Down Syndrome was far braver than I am.  The class agreed that it takes courage to struggle but still try (see Home of the Brave to read more on this).   I watched as each student and adult in the room looked again at those around them with an appreciation for who they were, rather than who they weren't.  A great day teaching.  A great day learning.

Retarded--the Most Misused Word

Retarded, this is word that brings many negative and ugly connotations.  It is misused to such an extent that there are many campaigns to eliminate its use including Spread the Word to End the Word.

But a mom of a beautiful young girl says it best in her blog, Herding Cats.  I thank her for her advocacy of not only her daughter but all of the people who happen to be cognitively delayed.

When No Isn't No

"No."  Two letters make a big word.  It is a word that indicates refusal, disinterest, or a different opinion. 

No.

Small children learn the word quickly and use it at every opportunity to assert their independence.  It is a word parents use to protect a crawling child from danger.

No!

It can clarify a statement to determine if it was dissent or confirmation

No?

In my class, I have a student who says "no" every time an adult speaks to him.  For him, "no" means..."Give me a minute to think." or  "I don't know what you are saying, could you say it another way?" or "Help me know if saying yes is safe."  Dor this young man, no isn't a refusal but rather a word he uses to protect himself from the unknown.  His limited receptive language has caused him to agree to things he was not very happy about so he is cautious and anxious about agreeing until he understands.  His limited expressive language and articulation struggles leave him with the simple but eloquent, no.  Given time to process, he is usually happy to comply and grins with the success of both protecting himself from the unknown and pleasing the adult.

Confidence is a great thing!

(Shared with permission from the child's parents)

This young man reminds me every time he declares "no" that processing and think time is not only critical, it is the only way to give the student the feeling of safety and security that we all want for each of our students and children.