Sunday, 27 September 2015

Lucy uses social referencing to co-regulate (YAY!!)



I am writing in black and Sharon’s feedback is in blue.

I popped into this session to do some modelling for Emma, as it was her first time working with Lucy and I knew how nerve-racking that can be from when I came out of my first session with Lucy dripping like a wet rag!!    I can relate to that... unpredictability re how Lucy may or may not react & how full on you may need to be = high!!!  I have the easy job here :) 

video


Nice setup / invite to join at the beginning.

Clip 1

0.25 Lucy tries to turn the page but I move the book away and say 'it’s not time yet'

0.44 - She goes to turn the page and references me!!  This was in response to your intake of breath. I reference her and say 'it’s not time yet' 

Clip 2 - More declarative comments and then 'time to turn' at 0.54

When I say 'it’s not time to turn yet, Lucy always seems to sing the same refrain - I'm wondering if this is perhaps a) a form of self-regulation or b) she associates the refrain with it being time/not time to do something??

Clip 3

1.15 She references me before turning the page (YES!!) and I say 'it’s not time yet'

Clip 4

1.28 Lucy sings the refrain, moves her hand to turn the page and references me at 1.29.  I catch her reference and say it’s not time yet. 

Clip 5

1.31 She moves to turn the page, references me and lets go of the page (YAY!).  This time I use non-verbal communication to say 'no' and follow it up with a verbal (I wish I hadn't used words!!)

1.40 I pause after using a declarative comment and offer her the page corner great drop in scaffolding!!  She turns the page

1.49 She reaches to turn the page, hesitates this is in response to your sudden body movement acting as an indirect prompt and references me.  I shake my head and follow up with 'not yet' (again I wish I hadn't come in with a verbal here I'm actually not sure that this doesn't act as a spotlight of her success, as you say it very quietly & gently?!?!?)

2.15 Lucy goes to turn the page and at 2.15 references me.  I use facial expression to signify 'not yet' and laugh as if to say 'ooops!'  At last - no verbals from me!  Zoe this is great... I personally think you are now in the mode of 'just me & Lucy' (not being distracted by Emma being there – this was happening a little earlier) which is why you have switched onto lowering those scaffolds further.

2.38 Lucy moves to turn the page whilst I am still talking. 4.46 She references me and I shake my head.  She stops (whoop!) double whoop, whoop!!

(Ed’s note – Sharon and I are whooping here because Lucy is using social referencing to co-regulate her actions with mine in order that we can reach a joint goal. Here, the joint goal is reading the book together and we each have specific co-regulatory roles that complement each other: my role is ‘reader’ and Lucy’s role is ‘page-turner’.  Without those co-regulatory roles, we are not in ‘together’ mode.  In the past, when Lucy has ‘read’ a book at school, she has taken the book over to her own space and looked at it on her own.  Anyone who has been with her has been observing rather than participating.......no 'together' at all.

Here, Lucy is looking at my face for information about what to do next so that we can stay in the co-regulatory pattern.  She takes on board my shake of the head and uses that information to inhibit her action of turning the page……she is adjusting her actions in order to accommodate the needs of her communication partner.

The ability to adjust our actions in response to the feedback of our communication partner/s is the cornerstone of all communication.)

2.45 I offer the page corner and she turns

2.52 I comment to say I can’t see the page - to see if she registers this.  She doesn't and I say 'now I can see' at 3.05 after she has let go of the page.  Yes this demonstrates that Lucy is not anywhere near this stage of development yet... I think it was old Stage 3 maybe 4!?!?

3.15 She starts singing the refrain and references me.  I nod and offer her the page corner. The scaffolding has been able to be dropped immensely in such a short space of time... I'm absolutely amazed.  She is already a different child to those initial clips of her in Nursery.  You are all doing such a wonderful job with her.  (Ed’s note: *blushes* on behalf of school staff)

At the end, Lucy tries to take the book off me but I hold onto it and say I am going to give it to Emma so they can read together if she wants to read it again.  I think this is another of those difficult to call from observation.... it seems that Lucy was already starting to let go of the book in response to your comment, do you think that was the case?  If not then that would be an area to think about.... model what you want to see is my motto... if you don't want Lucy to grab things from another then you need to model the pause of waiting for another to hand the object over.  This is similar to the feedback given over the parting with toys rather than taking from her.

(Ed’s note: I think Sharon is right here, having looked back at the footage – Lucy was already starting to let go of the book so no further comment from me was necessary.)

Where to: I really have nothing to add other than you will need to be pre-planning lowering of scaffolding as Lucy seems to be catching on at an amazing rate that she plays a role within interactions!  Looks like she could be keeping us on our toes :)
 
My final comment is that me and Jo (Lucy’s keyworker) have been ridiculously excited this week with the progress Lucy is making.  It just goes to show the power of getting the environment and the communication and interaction framework right.  Love RDI.  Love my job.

Monday, 14 September 2015

Meet Lucy

Lucy is a delightful 5 year old who has just started at Bright Futures School this September.  Her parents have given permission for me to blog about and to publically share footage of some of the work we do with Lucy at school – I am very grateful for this (thanks Rachel and Paul) and very excited to have Lucy at our school……not only because she is lovely, engaging and has a great sense of fun but also because working with her will present us with an opportunity to work with a very young child, and to document her (and our) progress on our social communication journey together starting from very early developmental milestones.
Lucy is quite different to our current cohort of pupils – our other pupils are verbally articulate and have mastered the basics of social interaction: joint attention; co-regulation; social referencing; experience-sharing.
Lucy has some functional speech but hasn’t yet fully mastered the crucial competencies above, which, in typical development, we would expect to be mastered at between 9 months to one year.  She is still very much ‘on her own agenda’ and is unaware of the needs of her communication partner/s.  She does not generally look to communication partners for information that can help her work out what to do when faced with uncertainty.
Here is some footage of my second session with Lucy.  I had observed her working with another member of staff previously so had an inkling of what to expect.  My mental goal when I went into the session was to join Lucy in whatever activity interested her and to try to establish a simple turn-taking pattern.
We knew that she liked toy animals so we had those available on the table.
video
You can see from this footage that Lucy doesn’t orient to me when I use her name.  Neither does she pay attention to the noise of the lion that I am trying to share with her.  She is unable to co-regulate by making the noise of the horse (the noise may be too difficult for her or she’s not interested in making animal noises).  Lucy puts the horse on the floor and then takes my lion (breaking the co-regulatory turn-taking pattern).  I spotlight to her that it’s my lion and hold out my hand but this doesn’t register with her.  She becomes distracted by the pictures on the wall and identifies Nemo.  I remind Lucy that the horse has gone on the floor and this seems to re-gain her attention – she puts the lion on the floor.  I quickly take control of the animals so I can put a turn-taking pattern in place.  Sarah and I take our turns and Lucy picks out the giraffe to put on the floor.  We take turns again and then Lucy picks out the mouse.
It’s lovely when Lucy initiates sharing emotion around the mouse noise: ‘eeek, eeek’.  She has remembered this from her last visit, and she does reference me around this, which is good.  It’s clear that Lucy’s receptive language is ahead of her expressive language – she has no trouble responding to me when I ask her to sit more stably in the chair.  The rest of the session after the clip ends continues with us taking turns to place toys on the floor and then taking turns to put them back in the box.  We do try out the books and some other toys but Lucy wants to stay with the putting and placing, so we go with that.
I wasn’t sure where to go from here so I did what we all do/need to be able to do when in a state of uncertainty – I referenced someone who I trust……my fellow RDI Consultant, Sharon.
Sharon works with Bright Futures School to support some of our staff in their ‘guiding’ (RDI) training, as well as mentoring my guiding (RDI practice).  She is very experienced and highly intuitive (much more so than me) about using the principles and practice of RDI.
Sharon suggested that we start right at the beginning stage of co-regulation with Lucy – a stage that in RDI, is called ‘synchronous co-regulation’.  Here is Sharon’s guidance:
Synchronous Co-Regulation refers to an important component of synchrony, involving feeling one's bodily connection with others. Through joint synchronized, rhythmic & patterned movement we pleasurably experience ourselves and others functioning as a single entity.
So what does that mean?  With babies they are rocked & gently bounced to soothe them.  As they get a little older parents/carers will use movement & nursery rhymes whilst adding anticipation i.e. with Humpty Dumpty the child will be on the carer's knee, anticipation will be added before they are dropped & pulled back up again.  In Ring-a-Roses anticipation will be added before the 'all fall down'.  Before a child is picked up, movement will take place i.e. holding out arms to child, child hold arms out to parent... anticipation can be added before picking the child up by pretending they are too heavy to lift etc.
Where can we take this?   Find & use Lucy's favourite nursery rhymes.  Do those action songs in which there is body contact i.e. as above or ‘Row Your Boat’, 'This is the Way the Ladies Ride', 'Round & Round the Garden', 'This little Piggy', even 'Peek-a-boo' with just hands to begin with....any others you can think of.   Add anticipation in whatever you use.
Although the above are without objects I also wonder how successful using bubbles would be.... most kids love bubbles!  If using these, I would suggest that either you direct Lucy to sit on a chair, or on a mat/cushion on the floor, before blowing.  Build anticipation around a pattern of you blowing & Lucy popping but each time before you blow, have her sit back on the chair/mat/cushion before you start the pattern again.
With any of the above we are looking for Lucy to recognise that she has a role to play.
So with this in mind, I went into my next session with Lucy armed with a list of nursery rhymes and early years action songs (it’s a while since I’ve used any of those!).
video
We are now in Lucy’s room at school.  Distractions have been minimised and we have started off again with the game of throwing the toy animals.  Lucy had thrown 4 animals so I pick out 4 to throw.  I build anticipation by giving ‘ready, steady, go’ a shot and it pays off with Lucy co-regulating by saying ‘go’ when I pause.  She comes in with ‘go’ again with the dog and I make sure to throw as soon as she says this so that we are building up a co-reg pattern.  We repeat this with the cat and then with another dog where she whispers ‘go’.
video
I try out ‘The Wheels on the Bus’ and I’m really happy to see Lucy co-regulate by joining in on the actions to the horn, chatter (bit of a tricky manoeuvre but she approximates it by moving her hand), up and down, wave and repeat horn.  This is great as we are establishing a connection :)
video
I do Incy Wincy Spider and on ‘rain’ she does a ‘washing down’ action and follows it with a 'climbing up the spout' action.  I celebrate by clapping and it’s lovely to see Lucy join the ‘we did it’ celebration.
So….we’re really happy with these little bits of co-regulation and connection as they give us a great base to build from.  As Sharon said, slow and steady for now whilst we build up trust and get to know each other.  We’ll add in ‘just noticeable differences’ and variations as we get to know Lucy’s edge of competence.  We don’t want to tip her over into withdrawal if the challenge is too big and we need to make sure that the activities we are using as the vehicle for our ‘goal beneath the goal’ (our developmental objectives) are activities that she is interested in and in which she has a competent co-regulatory role to play.
Over the coming weeks I’ll share some footage of other staff working with Lucy too.  I hope you enjoy joining us in our developmental journey.