Generalization.

At our weekly ABA meetings, we discuss any concerns about my son’s development.  There is not a week that goes by without a concern.  He’s not brushing his teeth.  He melts when I try to comb or brush his hair.  His screaming has escalated.  He doesn’t eat.  The list goes on.

The idea is that the team will add a program to address these concerns.  Some issues are long-standing (eating for example). Some have been addressed and reappear.  Some are addressed and considered “mastered.”  That means that my son is responding “correctly” in most instances during the program, with the tutors.  I don’t know the percentage before the program is considered mastered but I’d say it’s in 80-100 percent range.

Once a program is mastered, there is a term called generalization.  When it was first described to me, I was excited and hopeful.  It meant that the skills being taught to my son were now being turned over to me, his dad, and everyone he encounters.  Generalization, I learned, doesn’t always work.  In my son’s case, generalization probably works more than not.  But, let me just put it this way.  Rather than looking forward to “generalization” these days, I often get a feeling of dread.

Generalization occurs at the end of a “senior tutor shift.  Our “senior” tutor is the tutor who knows, creates and individualizes most, if not all of the programs used to address my son’s behavioral issues.  She brings my son to me at the end of the shift.  When she hands him over with paper, I know those papers are “generalization” data sheets.  She is transferring a program to me.  No longer the naive parent I once was, I know this means that I am supposed to record his compliance with being told to perform this new skill. I don’t like to take data.  I often don’t remember to take data.  And my kid is so busy working me if he doesn’t like a program, generalization often fails.  If not with me, then with others, like his dad.

Don’t get me wrong.  I’m always excited when he “masters” a program but the “mastery” often doesn’t include me and when it doesn’t, the program is put “on hold” and other things are pursued.  At first, I thought mastering meant it would just naturally transfer to all settings.  Not so.  He will refuse and ignore my instructions.  By far, though, the biggest obstacle to him completing any task is his wandering mind.

It’s not that he does not understand.  It’s that he gets lost in the middle of any given task.  He will start and then get absorbed in some thought completely unrelated to the task at hand.  I have to bring him back.  It will take a “No,” prompt (and he hates those and cusses – again with equations, “Gordon!” or “Fire truck”) before he focuses back on what he is supposed to be doing.

Right now, he’s working on “getting dressed”.  From nudity, he has to put on his clothes (undies, shorts and a shirt) on his own.

I can leave him alone after giving him the statement, “Get dressed,” and come back five minutes later to find him unclothed, on the bed, watching TV or playing with his iPad.  I have found him with only his shirt over his butt as though it is his shorts.  I’ve found him with both feet in one leg of his shorts.  His clothes have been on backward.

“Get dressed,” I said that first time, cheerfully, forceful (and yes that is possible).

“ONE PLUS FIVE EQUALS SIX!” he yelled back.  This was followed by mumbling to himself and grabbing for his undies.  Then, he sits up and looks off in the distance and mumbles, undies at his ankles or not yet on at all.

“No, get dressed,”  I remind him.

“PLUS ONE, PLUS 2+8= 10!” he cusses.

He lays on the bed and doesn’t move.

“Wanna start over?” I ask.  (He hates starting over with anything.)

“Yes. NO!” he responds. He continues to lay dormant on the bed.

I watch.

He finally pulls up the undies after about five minutes of delay.  He hasn’t checked for the tag as he’s been taught and is wearing them backward.  He has to start over.

After that, it took him six more minutes to put on his shorts.  He is ready to leave the house shirtless. I prompt him to go back and put on his shirt.  That process looks a lot like this:

Look for tag.

Ask Mom to read tag.

Wrong hole.

Now what?

Hoping it’s the right hole.

I got this on backward, don’t I?

With the tank tops, he gets confused by the arm versus the head hole.  His head is too big for either, but since the arm holes on the tanks are almost as large as the head hole, I redirect him on this. The first time, after generalization, it took about 15 minutes and ended with a good cry.

I felt like this:

The second time he put on all his clothes in a little over a minute and a half!  Front versus back was pure luck.  On average, it’s takes about 10 minutes to put those three items on, with multiple, repeated prompts.

Another previously generalized program was “sitting for meals” where he is supposed to remain seated until he finishes his food.  Currently, he stays for one bite, gets up, is prompted to sit back down and – repeat.  No success there at all.

And then there was “brushing hair” where he is has to stay seated, not grab my hand and not scream.  He executes this perfectly for his tutors and for me, in front of the tutors.  In real life?  When he’s up first thing in the morning or out of the tub, there is grabbing, yelling, screaming equations and running away.

So, yeah, “yay” for generalization.

Maybe, someday, in time, it will work.

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About solodialogue

I'm a lawyer and the mom of a 6 year old boy with autism. I work part time and spend the rest driving here and there and everywhere for my son's various therapies. Instead of trying cases, I now play Pac-man and watch SpongeBob. I wear old sweaters and jeans and always, always flat shoes to run after my son. Yeah, it's different but I wouldn't change it for anything. The love of my child is the most powerful, beautiful and rewarding aspect of my life.
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25 Responses to Generalization.

  1. Mom2MissK says:

    This is the part of Little Miss’s new school that I am looking forward to LEAST. I think she and T could really give us a generalization run for the money if they ever got together!

  2. Flannery says:

    Yep, that’s the part of ABA that I HATE. We still have to give multiple prompts for tasks, because Connor gets distracted way too easily. But yes, there came a point where we had to stop doing things for him, like getting him dressed. It takes time, and some meltdowns, but it will eventually pay off. If it’s any consolation, Tootles is already better at math than Connor is!!

  3. Mary says:

    I learned a new word today. Generalization never seems to work for us. Maybe our OTs should come to the house first thing in the morning? Although, to be fair, most of our OTs had their own kids with their own issues to deal with in the mornings. :/

    School started last week. We are back to the same old song:

    I didn’t sleep.
    I’m tired.
    Why do I have to go to school anyway?
    I hate you.
    I hate all my clothes.
    AAAGGGHHH! My pants are up my butt!
    My socks won’t go on.
    This stupid shoe!
    I’m not going to school.
    I want nothing for breakfast.
    AAACCKK!! My hair is all staticyyyyyy!!!!!

    We don’t even discuss the toothbrush anymore. By the time I get her to school, I’m exhausted.

    Last spring we did a chart with stickers and a giant stuffed panda when she got 100 stickers. She did it and started working toward a Lego Friends house, but she quit getting up on her own so I quit giving the stickers… Since we’re (mostly) gluten-free now, maybe I could bribe her with McDonald’s fries or something. I don’t know.

    If I let her watch TV in the morning, she would never make it.

    • solodialogue says:

      There’s something comforting in knowing you’re not alone, at least for me! Do you have ABA, Mary? So much of this is intertwined between OT and ABA. As for TV, I have to learn to hide the remote! And who wouldn’t work for delicious McDonalds fries?! 😉

      • Mary says:

        I’d never heard of ABA until I saw your blog, but I think it was part of our OT. Like you say, intertwined. She would do what they wanted at OT most of the time but not at home. That’s one reason we gave up on food group. She loved a new food they gave her but hated it when I bought it. Same brand. I checked. Sometimes I think she just wants to drive me up a tree.

        We don’t have any OT right now. She likes school once she gets there and she LOVES her new teacher. All her teachers really. Even the new gym teacher. He had them walk like Frankenstein and touch their legs(raise them up?). And he didn’t yell like the previous guy. Maybe I can get her teacher to pass out treats to the kids who get there early? Secretly, of course. Freckles can’t know it was my idea.

        We are on year six of this morning insanity. At least they don’t have to physically drag her in the building like they did in preschool. That’s progress, right? 😀 I am open to suggestions from anyone on this.

      • solodialogue says:

        Mary, if you have a chance, can you just glance at this and let me know what you think? http://palsautism.com/faqs.html Thanks! 🙂

  4. Mary says:

    That seems very different from what we got. First, it’s a lot more intense. We got 1-2 hours per week, but Freckles is diagnosed SPD and not ASD. Some of the kids had a lot more therapy than we did. Still nowhere near 40 hours a week.

    Second, often it was more like the example given for the non-discrete teaching. OT: “Can you tell your mom what we did today?” Freckles: (silent evil stare).

    Third, Freckles wasn’t diagnosed until she was 6yo. She could talk so the doctor didn’t “see” anything wrong with her. We went to a family doctor and not a pediatrician. I am still questioning that decision. When the neurologist asked me who diagnosed Freckles, I said, “I did.” The psychiatrist wrote it down for me in terms the insurance company would understand, but I am the one who figured it out. Would ABA have been more effective when she was little? Most likely. But at 9yo? I don’t know.

    I still don’t understand how we are supposed to translate what they learn in any therapy to the real world. They know the difference. Freckles just doesn’t seem to care. She knows she’s different. Sometimes she will break down because the other kids treat her like she’s different. But most of the time, she is happy to do her own thing. Well, happy may be too strong a word. Content maybe?

    • solodialogue says:

      I have heard many stories from parents who did not get an ASD diagnosis from their providers, especially girls. Toots still is unable to tell me what he did for the day but if I ask him specifics, “What did you eat for snack today?” he is able to give me an accurate answer. The whole “what I did” is too big a question for him. I know Freckles is older but 9 is a mere babe still! I read a study that, even as adults, we still are able to benefit from learning and from these types of programs. Yes, I know the site I directed you too talks about the importance of early intervention and I don’t discount that but even in the PBS autism special in which we participated, the experts say that you will continue to benefit from these programs beyond the years of early intervention.

      I hate that she is breaking down because the other kids are treating her differently. Perhaps it is not that she doesn’t seem to care but what can she do? I don’t know where you are located but maybe there is an ABA program that could provide her with some kind of service or get you in touch with someone who could offer a second opinion on diagnosis? Just a thought. I don’t want to seem pushy, just offering help if I can. xoxo

      • Mary says:

        Not pushy at all. I wish someone had been pushy 8 years ago or so.

        I don’t know about the ASD diagnosis… One psychologist said she fit the DSM diagnosis of Asperger’s. So I asked the OT at the time and she said, “No, not unless she’s very high functioning.” So I trusted my OT.

        The neurologist referred us to the psychiatrists who no longer take our insurance so this has left me scrambling to find someone to see her. I try for a couple hours and then give up. I did look into it today and there are some ABA therapists in the area so I will keep trying.

        My brother’s son has Asperger’s so there may be something to the difference in diagnosis for boys vs. girls. I know there is with ADHD/ADD. I more than meet the diagnosis for ADD, but I wasn’t diagnosed until 2 years ago after first being misdiagnosed with bipolar disorder. Freckles’ OT at the time told me, “You don’t have bipolar disorder. You just have a low arousal threshhold.” I still laugh about that.

        My 15yo almost certainly has ADD. But she and I agreed that a formal diagnosis won’t benefit her because she would just use it as an excuse not to get her homework done on time. Freckles isn’t diagnosed with ADD because the school insisted she didn’t have it. It might be time to look into that again.

        She will tell me about school sometimes with and sometimes without prompts. I’ve been asking who she ate lunch with and who she played with on the playground. One of her best friends, a boy, sits with her at lunch, but today she said she followed 2 other girls around on the playground. I’m not sure how to take that. In the past, she has told me someone was her best friend and it was more that the person was just nice to everyone.

      • solodialogue says:

        I did not have a perfect road to a diagnosis for Toots either. He was high-functioning enough to stop my own pediatrician from saying anything until he was over 3.5 years old. We were on a waiting list for diagnosis. I had to push and prod and research to finally get a diagnosis and then I was left holding a piece of paper with no direction. I think I was just plain lucky for Pacific Autism Learning Service to come up on Google on the about 1000th time I googled for ABA providers. I understand about trusting. Since Freckles is receiving OT, I’m guessing you have an IEP in place? If not, you can always demand a new assessment by the school district or if it’s been a while since the last diagnosis, the school should pay for the assessment and determination. It just depends on what you think is right or what you can get out of it for her. You might just want to contact any local ABA provider. They will talk to you for no charge for some time to see if they can help. I remember talking to one provider for over a half hour when I was looking for someone to provide services where we live, which is in a remote location. A few phone calls and a quick written request to the school certainly couldn’t hurt, right? Sending lots of love and positive energy your way!

  5. Lisa says:

    I finally have a moment to write!! This entire blog post could have been written by yours truly. We struggle with the generalization. I stink at recording data…in fact, I pretty much don’t do it any more. I know that’s TERRIBLE in ABA, but it’s just low on my priority list. I fill them in, but that’s about it.

    We are battling the self-dressing right now, as well. Tate literally ran around in his underwear all day last Thursday and most of Friday. He chose not to put his clothes on, and I was not going to do it for him. Fun, fun times….(P.S. He also tries to use an arm hole for his noggin…)

    The sitting for meals is also not going well for Tate. He will sit, but ONLY if he has an electronic device. Part of the purpose of a FAMILY DINNER is to connect and socialize..and he struggles mightily with that.

    I’m somewhat dreading school…he has mastered so many programs in therapy this summer…but I somehow feel that they just won’t generalize to the classroom…drat!

    • solodialogue says:

      I have to record data on my phone. If I try to write it on the paper they give me, I never remember to bring the paper back to our office where he has therapy! And I completely suck at taking data because it takes forever to write down what happens in 60 seconds! If I let Toots run around in his undies, he most definitely will. When I leave him alone, he will run around in undies until I tell him to put his shorts on and it’s been 110 degrees here so, I have little motivation to push him! That is so weird how alike the boys are! Toots has mastered a lot this summer too but when it comes to class? I guess we’ll just wait and see…

    • Teresa says:

      When my son was young my mother in law gave us her kitchen table and chair set. It was hardly used but she had carpet in her kitchen and the chairs were on casters so wouldn’t move well enough for her. The first night we sat down to eat and I realized it was a mistake. Like you, we used family dinner as an opportunity to be interactive. We also struggled with it. Once my son realized he had wheels on his chair he spent his whole time zipping around the room.
      Yes, in no time, I got a new kitchen set.
      Teresa

  6. Teresa says:

    Karen,
    I also wanted to say, as others already have, our kids are really clever at realizing they have more than one set of rules. One for school, one for home, sometimes one for dad… And the same with our schedule. I realized how significant it was when first bringing son home to be home educated. Always before when he was home it was because he was sick. Suddenly, he was home and expected to do the dreaded ‘work’. It took time and patience to get us all on the same page.

    In my experience these smart guys really know how to read us parents. They know if we’re tired, it’s late, or we have to this, that and the other before the end of the day and if they hold out long enough we’ll cave first. Sometimes you even see the little glint in their eye. Patience and consistency will win out but it can be a mighty struggle.

    Hang in there. You are making such good headway!
    Teresa

    • solodialogue says:

      Oh Teresa! I know how exactly what you mean about knowing how to read us parents. There are different standards at our house. He behaves one way with me and (totally) manipulates his dad a different way! 😉 That change to home schooling must’ve been some transition for you! Thanks for the encouragement. And ha- yes “headway”! Don’t think I didn’t notice that…

  7. Karen,
    With the dressing…I remember when Random Guy went off to Kindergarten and I said to him, “I shouldn’t have to dress you anymore, you are in grade school now.” He didn’t like that. I gradually backed off on each step. For example, instead of putting his sock on him, I just put it over his toes, and he pulled them up the rest of the way. Instead of putting his shirt over his head I would lay it out for him with the bottom opened up so he could slip it on the right way. It takes longer this way but he’s been dressing himself independently since he was part way through 1st grade. Sensi can get her underwear, and pants on, but not her top without help to keep it straight. She won’t do any of it if left unsupervised. I have to prompt her for each step. I think this method might be called fading. Moving from physical assistance to physical cues, then verbal cues. This method might be worth a shot if he isn’t taking to generalizing the skills the other way. It will get better, it just takes a long time. You don’t even realize things have changed until after it has happened. Keep working on it. 🙂

    • solodialogue says:

      Fading is a term I have heard too but not as often. I like your approach. It seems like a sort of sneaky teaching. 😉

      I would have tried this but we’re past that stage now. I know he is capable of all these steps. It’s just how much he will work me to not have to do it. Now, do you have any tips for hair combing? Because I could very much use those! 🙂

  8. Mary says:

    Oh, and something that worked for us at dinner… Freckles was all over the room, knees over the table, kicking her sister. Finally I figured out that she was just short. So I bought her a $10 chair cushion from Wal-mart. About 80% improvement immediately. Definitely worth a shot.

  9. eof737 says:

    You’ve become quite the documentarian with all those candid photos you take of Tootles… Toots is okay with me. Stay strong. 😉

  10. Great post. Loved the photos of him getting dressed…..And I laughed out loud at “And I felt like this” That donkey photo is priceless. 🙂 hehehe…..Keep doing the super job you are doing. You are such a wonderful mom. Hugs, Sam 🙂

  11. Love these photos and this post. I can totally understand your frustrations. I have the hardest time getting Joel interested in learning how to dress himself, much less getting him interested in staying dressed. 🙂 And, while Joel isn’t involved in an ABA program, I feel pretty safe in saying the generalization part would not be my favorite aspect either.

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