Sunday, November 15, 2009

Thinking In and Out of the Xbox: Persevering with PDD

I need to write about Xbox (obviously not his real name; I'm masking him under this name because he would always murmur about games in Xbox or some computer-related phrases like "page loading error" or "download complete"), a 4-year-old boy in my class with PDD-NOS (Pervasive Developmental Disorder - Not Otherwise Specified), which in his case mainly means a marked challenge in communication, social interaction, and in processing stimulus and information. More concretely, that means he doesn't converse with his teachers and classmates--he talks, but his sentences are d-i-s-j-o-i-n-t-e-d and they seem to come from out of no where. Or everywhere! Because X is like a "reading prodigy" who suddenly and inexplicably read at 2, without anyone teaching him; he reads ALOUD just about anything he sees. Stimulus and information come to him in barrages so he's mostly excited, uneasy, confused all at once. Among other things, he doesn't have eye contact; he takes a while to respond to his name; he runs around and laughs aloud indefatigably.

I need to write about him because I need to think more about him; and maybe through writing, just as the way it has worked for me in the past, I can take just the right amount of steps back enough for me to make more sense of him and the world, the box, he is in. And also, maybe, through writing; I can take a c l o s e r, c l o s e r, cl os er, closer and honest look at myself.

What Works: As a teacher, I have always said that I should be proactive rather than reactive. I must have anticipated different classroom scenarios and must have prepared different classroom/child management strategies based on what works for each and every child. If someone breaks a glass from the Practical Life shelf, I should know better than "AAAHHH! Oh no!". Proactive instead of reactive, for me, also means being able to stop; breathe; rein in reaction; quickly assess a sudden, surprise situation; and act upon it with the usual and necessary respect for the child. So I refuse to just adhere to what X's therapist says to him, "If you don't [insert command/expectation here], I will put you in a corner!" At best, it elicits only a transient pseudo-obedience. These are what works for Xbox so far.
1. Making him aware of his body. When he's been running around, I just stand where I anticipate he will eventually pass, and when he does pass, I catch him in my arms. I do this because if I chase him, he will probably just think I was playing with him. When he's finally with me, I put his hand to his heart and say, "X, feel your heart. It is beating too fast. That means you will get tired, why don't you rest first." We also do some breathing exercises. "Can you put your pointer finger out. Breathe and bring your pointer finger on the tip of your nose (inhale). Now blow slowly and quietly (exhale, move the pointer away from the nose). Let's do it again." X will then be ready for me to introduce a work to him, and recently he has been choosing and getting work out by himself already.
2. Calming him down by counting.
In the past, I have helped crying children calm down by counting, I'd say, "Let's count some thing you like. Maybe butterflies? Or cars? 1 car, 2 cars, 3 cars, etc. You have to be a little quiet so you can hear me count." We'll count while I wipe their tears and I usually ask them to wash their hands and their face because water is inherently soothing. I found that this has helped children shift their focus to just my counting and has helped them calm down.

I wondered if this will work with X, too, for focus and calm. I wanted to help X be more ready for circle time. Storytelling has been a challenge because he would usually rush up in front of the book and blurt out whatever he reads there. So I started him with calm counting, "X, let's see if you can be ready (he knows that ready means his sitting on the circle, his legs are crossed, and his hands are on his lap) while I count 1 to 5." In my softest and calmest voice, I counted. 1... 2... By 3 he was already fidgeting with his fingers. I try again. By 5 he was already glancing sideways. Tried again. This would only work if I'm calm, too. A few more tries later, we reached counting up to 10 with X sitting very still. I tried to see how long he can go. 15. 20. 25. 30. 40. 50. A whole minute! X's father came in, saw this, and was very happy.
That would be the first time in his entire life that X has sat quiet and still.

Another day, I tried something else. "X, let's see if you can be ready while Teacher Mars reads this story." I read 'Goodnight Moon' by Margaret Wise Brown. And then we moved on to longer stories. And by the time we had our United Nations program last October, X was able to sit and sing for one whole hour!

3. Letting him do things by himself. One distinct and disruptive thing about X when he first came to class last June was that he whines when he needs something and he just waits for someone to notice him and figure out what he needs. Whines and waits, then whines some more. In school, this usually happens when he eats because he couldn't open his snacks. Some would just go ahead and open them for him, just to get it over with. But I wanted X to be more independent. "Teach me how to do it by myself." And using the scissors will help develop his fine motor skills. So I insisted that he open his own snacks by himself. I drew broken black lines on his snack packs so he'll know just where to cut. Pretty soon, I was able to say, "X, today I will not draw black lines. Can you just imagine there are black lines right here and cut?" He did. And he has been eating independently now--even packing away and sweeping right after.

More Work:With less than five months of this school year to go, X and I have much to work on. One is talking within a topic. I'm starting weekly sharing sessions and we'll see where that goes.

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