This week we had to make some accommodation for self-regulation and communication. Joey typically uses an eye gaze device for communication, but when he is on the ground as we need to be for physical OT work, he is unable to access this device. To give him a form of communication even without his device, we use some simple signs and give two choices holding out hands to correspond with each choice. Joey can then pick which hand/choice and have more control over the situation. He has been introduced to a variety of signs including more (mastered and easily recognized) all done (emerging), thank you (mastered and easily recognized), please (mastered and easily recognized), and help (emerging). He is encouraged to use the signs to communicate when he is visibly frustrated, crying, or kicking with his feet. This is not as helpful as his eye gaze communication device, but allows the adults helping him to understand the root of his frustration or sadness and address it appropriately.
Joey can get frustrated and show decreased goal-directed persistence (pushing through difficulties to finish a task) especially with placing the coins into the slot on his box. He much prefers to do the squigz, as he has improved in his manipulation of squigz and has more instant gratification when placing them into the box, typically getting it within his first few attempts. (Squigz are easier to grasp because they have a bulb on them where the coins are flat). This is where the help sign would be useful.
Week Five Areas of Challenge: Self-regulation and communication. This is becoming an area of challenge for most families as they progress further into the weeks of no school or virtual school to structure their days. We addressed it by continuing to build and remind Joey of his sign language to communicate rather than kicking or crying.
Week Five Areas of Success: Joey has enjoyed placing squigz in the box so much, it’s reported he even does this when he’s not in OT. Playful engagement that the child is willing to do outside of therapy is valuable to build motor memory and motor strength.