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Tuesday, July 26, 2011

High functioning client keeps me on my toes!

People always ask me if working with higher funtioning children with Autism is easier. I always give the answer of "yes and no." I have a 4 year old client who is higher functioning, which means that as far as skills she has many. Her issues are mainly social and behavioral in nature. The skills that we work on are mainly everyday social skills such as greeting people, requesting attention, and proper conversation skills. One of the skills that she needs work on is greeting other children. We work on this sometimes at the park or playground. I have to be "quick on my toes" because each time I give her a reason as to why it is important to be able to greet and talk to other children, she always has an excuse as to why she doesn't think this skill is necessary. For example, before we practiced the skill (going up to a child and saying "Excuse me, Hi"), I explained to her that saying "hi" to other kids is a good way to make friends. And this was the exchange that occured...

Client: "I have friends and I didn't say "hi" to them."
Me: "Well they said "hi" to you and that's how you became their friend."
Client: "Then I don't have to say "hi", just wait for them to say "hi" to me."
Me: "Yes, you can do that, but it would be nice if you can say "hi" first."
Client: "No, it will not be nice."
Me: "Why not"
Client: "Because I have to say "hi" and I don't want to say "hi" so it will not be nice for me."
Me: "Oh, I see." (At this point I am having to think of another way to respond in a way that she cannot argue with.)

Therefore, I realized that she will need a reinforcer to be motivated to complete the task. The reinforcer (ice cream) worked and she was able to say "hi" to three kids. The ultimate goal is for this skill to be generalized, but for now I can see that she will need a good reinforcer to complete this task.

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