Sunday 31 July 2016

Using guiding to help engagement and enjoyment

In my guest post for Special Needs Jungle I looked at the ‘guided participation relationship’ – this is the name for the framework we can put around our children with autism to enable them to engage reciprocally with us and for us to enable co-regulation – the basis for all human communication.

Let’s recap on what needs to be in place (the GPR framework) in order to help kids with autism have another go at mastering missed milestones via the social interaction between parent/carer and child.

Framework for the GPR.

The guide must:

  • Be confident at setting limits and boundaries
  • Use a ratio of 80% non-verbal to 20% verbal communication. Where communication is verbal, remove demands or commands: use invitational language
  • Use roles to establish co-regulatory patterns (the way partners will work together towards their goal)
  • Slow the pace of interaction
  • Use pausing to facilitate thinking & social referencing and to enable the student to step into their role
  • Be able to gently support the student if they are struggling (scaffolding)
  • Use ‘spotlighting’ to bring the student’s attention to something
  • Be aware of the student’s ‘edge of competence’ so that the activity and any challenges are not going to over overwhelm the student (leading to withdrawal/avoidance due to too much uncertainty) or underwhelm the student (leading to withdrawal/avoidance due to boredom).
Here are two clips of Jo putting the GPR framework around Lucy in order to enable co-regulation. 

The first clip was filmed shortly after Lucy joined us at Bright Futures School.  The roles here are that Jo is the reader and Lucy is the page-turner.  The joint activity (reading the book) cannot succeed without each of them stepping into their role.  Each of their role actions is contingent on, but not controlled by the other’s actions.

Jo says’ Ready?’ and Lucy resists engagement by squirming about on the couch. This is hard for Lucy – prior to coming to Bright Futures School, she has not been in many situations where she has been a co-regulatory communication partner.  She has mostly been on her own agenda, so waiting for the other person to take their turn and stepping into her own role in a reciprocal framework is challenging.

0.13 Jo says declaratively, ‘I can’t read it when you’re upside down’

0.23 Jo waits and Lucy chooses to engage

0.27 Lucy feels the corner of the pages

0.36 Jo is sharing something about the picture.  At that point, waiting long enough to read a page was not possible because Lucy could not sustain her attention for that long.  Jo is using facial expression and prosody to convey her feelings about the teddy’s sadness, but Lucy cannot engage around this and is engaging in self-stimulatory behaviour (stimming).

0.44 Jo makes another comment about the picture.  Lucy goes to pick up the corner of the page and Jo puts her hand over it because she hadn’t finished doing her role action (reading) and this would have broken the co-regulatory pattern.  This challenges Lucy, causing her to withdraw.

0.59 Jo waits.  Lucy regulates and re-engages.  She steps into her role by turning the page.  Notice how much controlling of the equipment (the book) Jo has to do here: taking the page off Lucy and then putting her hand over the other page that Lucy is trying to turn!

1.09 Jo says, ‘My name’s Dotty’ and Lucy shrieks.  Jo’s face shows surprise at the shriek and Lucy says ‘Stop’ and disengages again.  I think here, Lucy interpreted Jo’s facial expression as disapproval.  Because she thinks this is a negative spotlight, she withdraws and avoids expectations by squirming again.

Jo continues to read the book, building anticipation and then invites Lucy to look by saying declaratively, ‘I don’t think you can see Maisie’s slippers!’

1.46 Lucy re-engages and turns the page.  Jo makes a declarative comment about knowing who that is and Lucy says ‘Cyril’, which Jo repeats.

Watching this clip again it’s making me laugh to remember what a struggle we used to have with Lucy’s hair (you can see here it is driving Jo mad!)……it really got in the way of sharing facial expressions.  Jo worked on it over a couple of months and Lucy now has no probs wearing hair clips……so we can see each other’s faces.

2.16 Lucy shares her thoughts about the ducks – they are naughty.  Jo shares a comment back.

2.37 Jo enables Lucy to co-regulate by stepping into her page-turning role.

Clip 2 is a very recent clip – so Lucy has now been at Bright Futures for nearly a whole academic year.  During this time, we have immersed her in guiding (derived from RDI).  We have not done any formal academic learning with her at all……we have been using the GPR to play…….just like parents of typically developing children do in the early years. 

Without being conscious of it, what we parents are doing in this early years play is helping our children to master developmental milestones.  With Lucy, each of us guides is using our relationship with her to provide the social interaction (interpersonal engagement) that gives her another chance to master those missed milestones.

0.08 Dynamic gaze!  Lucy is sharing her thoughts with Jo about what is happening in the book – Kipper (the dog) is standing on one leg.  Lucy looks to Jo (social referencing) in order to share her thinking with Jo, saying, ‘Wobble!’

0.26 Jo has taken the opportunity to spontaneously introduce a new role set – simultaneous parallel (same thing, same time…..both wobbling on one leg).

0.35 Lucy invites Jo to sit back down (how lovely is that?)

0.52 Lucy is still stimming with the page corners a little, but it doesn’t now get in the way of the co-regulatory pattern 

1.02 Look at that!  Lucy is anticipating what is going to happen next, referencing Jo around it and using gesture to convey her thinking.

1.08 Co-regulation with social referencing!  Lucy answers Jo’s ‘That’s not a rabbit hole!’ with ‘Badger hole.’

1.26 Lucy shares ‘He’s very tired’ (cuteness overload) and we have dynamic gaze again.

1.58 Lucy doesn’t want to continue without Jo (gulp) and says ‘Leave it’ as Jo excuses herself to check the camera.

2.59 Look at that emotion-sharing from Lucy.  She’s now able to fully enjoy the experience of reading a book together.

3.02 A delightful chuckle from Lucy as Jo builds anticipation about what’s going to happen next.   
More dynamic gaze.

3.04 Lucy touches Jo – physical connection as well as emotional connection.

3.34 Lucy shares with Jo that Mousey is in the sock.

3.58 Dynamic gaze, prosody and gesture are used by Lucy to share her emotion with Jo around the disaster of ‘Got no cakes!’

4.24 Lucy is really enjoying this – when Jo puts the book down, Lucy picks it up again and says, ‘Read!’ whilst referencing Jo.  Jo checks the camera and Lucy declares ‘Leave it!’ (the book) because now, in contrast to the earlier clip, it is the sharing of the book that is important to her.

The social referencing, co-regulation, emotion-sharing and experience-sharing are what underpin Lucy’s enjoyment of this book reading session with Jo.  It’s not the book, it’s the reciprocal interaction around the book that is now the hook for Lucy. There is no disengagement, withdrawal or avoidance like there was in the earlier clip – in fact, quite the opposite.

Jo has facilitated this with the guiding tools of: slowing the pace; pausing for referencing; building anticipation; enabling Lucy to step into her co-regulatory role.  The backdrop to this is the trust that Jo has established with Lucy and Jo’s ability to set firm but fair limits and boundaries…….all of which are part of the GPR to enable that all-important interpersonal engagement.

Jo and Lucy have got their co-regulatory underpants on over their trousers. Go girls!!