Sunday, June 4, 2017

Smart but scattered- flexibility

I have written about the challenge of change before, and flexibility is little more than adapting to change. Yes, that is a huge understatement. Children who learn to be flexible and adaptable quickly tend to be easier to parent and teach. Children on the autism spectrum tend to be adverse to change to the point of rigidity. Social Thinking guru Michelle Garcia Winner, speaks about flexibility as an essential social skill. Sarah Ward of Cognitive Connections, which focuses on executive function skills, includes flexibility training in her programing. The authors of Smart but Scattered, Peg Dawson and Richard Guare, include this skill in their program as well.

Dawson and Guare define flexibility as "the ability to revise plans in the face of obstacles, setbacks, new information, or mistakes" ( p. 256). The Simpsons have a segment where Bart never learns to stop grabbing the electrified cupcake, showcasing his lack of flexibility around food. Although comical in the cartoon, parents and teachers who deal with children with a lack of flexibility have a definite challenge.

For years when we had a school break I would plan out a schedule and write it down for my rigid child. Once it was recorded, it was "set in stone." God forbid a change need to be made. My son's preschool class traded places with the class across the hall on Wednesdays to try and build in some flexibility. Unfortunately, once that had been done a few times, it was part of the schedule and my son was fine with it. A weekly schedule was just as good as a schedule for the hour. A Sarah Ward workshop I attended years ago spoke about introducing a surprise card to a picture schedule. These big schedule attempts are a good place to start.

Dawson and Guare discuss two types of interventions for flexibility: environmental and skill development. With skill development they include consequences that will encourage use of the skill.
Environmental modifications:
  • reduce amount of change at one instance- Instead of changing every expectation, change just one at a time. From summer to school, do not change bedtimes and daily routines together. Even though you do not need to get up for school- get up at the same time and go to bed at the same time and change where you go for the day. Do not schedule a dentist appointment on the same day there is going to be a babysitter at night because you are going out.
  • keep schedules and routines- create picture or word schedules for the day. Develop routines around daily events- getting up, going to bed, eating meals,... This enables them to predict what is going on. It showcases that non-preferred activities do not go on forever and can highlight preferred activities.
  • provide advance warnings of change- My son's bus driver attended a training where they suggested not telling kids if she was going to be absent because they would dwell on it all day. Yes, kids might dwell on it, but they will do better if you train them what to do when there is a change. You can tell kids about vacations. The classic 25 day advent calendar or chain to count down to Christmas provides warning of the change.
  • scripts for handling the situation- this has been a great activity for my son. Bibliotherapy and social stories about what do at the dentist solved problems in handling going to the dentist. We have talked through what a phone conversation might sound like before picking up the phone. This reduces the anxiety around the event.
  • reduce complexity of task- Instead of the long term project being presented at once, present only one piece at a time. Instead of pick up your room, pick up the clothes on the floor. Instead of make a phone call, dial the number.
  • give choices- we need to drop off this material after school. Do you want to have a granola bar in the car or wait until we get to the office and have a yogurt for snack? Do you want to practice your spelling with mom or dad? Do you want to go to the zoo or the park on the vacation? You need two fruits or vegetables out of these four choices: carrots, beans, applesauce or salad. Really important here- do not offer choices you cannot live with.
Skills and strategies to encourage flexibility:
  • walk a child through the task- ordering at a restaurant: we role played it at home, now we will do it together, eventually you will be able to do it on your own.
  • Use social stories- Carol Gray designed this evidence based practice. For a month before my son's first dentist visit, every day we read stories about going to the dentist and watched a Mr. Rodgers episode about it.  When we got there we took pictures of him doing the various steps so that we could look at them before the next visit. For getting ready to fly to his uncle's wedding, we again hit the library up, but then scripted each step of the event. For a student who did not like leaving preschool, we wrote one about waiting patiently to be picked up.
  • Come up with a default strategy. Think of the most problematic situations and brainstorm with your child (when they are calm!) about how to handle the situation. When we might need to wait, we bring a book to read/look at. Teaching counting to 10 to relax. Teach ask an adult for help.
  • Use coping strategies- like above. You need to teach when calm. You need to practice. You need to reinforce when they handle the change well. The authors recommend a number of Dawn Huebner's books to introduce these ideas.

Overall the authors say you need to teach it. Flexibility does come easily for some. If you are a very flexible person and your child is not, this may be especially challenging to deal with. Routines and schedules will not be your thing, but you need to work on doing what your child needs. If you are a fly-by-your-seat teacher, these kids need more structure or you will have behavior problems. Routines can save much angst, but kids also need tools to handle when routines are set aside. Increasing flexibility is critical to adult success.

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