Thinking through OT and what direction to go next

[mamashark]

Edited-  lot of rambling for the long story. The short story is that the OT was great on some things and not great on others, and I have to decide whether her focus is where I want to focus, because her attention to some things feels really scattered and causes more work for me as I have to take those things she starts and create usable ways to integrate them into our lives at home without the original resource to begin with. 

What I want is to know what resources I can utilize for Theory of the Mind so that I can integrate the color my conversation pieces into it. Something designed to give me resources to teach him perspective and thinking through social situations at various levels, starting at foundational levels. I was looking at the Thinking about You Thinking about Me, since he's already been through we thinkers 1 and 2 and it didn't go well - this is a more foundational piece I think.

I've got the anxiety piece under control, so now I feel free to work on the language and social pieces in more specific ways. I'm using 100% Vocabulary by Rothstein to look for gaps and issues there, but I just need to know what other resources will provide me the most usability. I was thinking about Think Talk Laugh to help with language organization and ensure word retrieval isn't an issue.

Anything else I'm missing?

Edited March 14, 2019 by mamashark

[PeterPan]

Ok, so I'll just laugh. I'm trying to read, but reality is most OT is floozy. Our current OT is less floozy and actually gets some results. But as far as being input/output, you spend money, things change, well... I'm pretty cynical. I drive 40 minutes each way to one, so I'm not too cynical. Just saying as a whole, it's the vaguest of therapy options.

Uh, theory of mind isn't the OT's gig anyway. They should be doing something concrete that falls in their territory.

This is what you're looking for. You'll LOVE it. Practical Theory of Mind Games

3 hours ago, mamashark said:

Something designed to give me resources to teach him perspective and thinking through social situations at various levels, starting at foundational levels. I was looking at the Thinking about You Thinking about Me, since he's already been through we thinkers 1 and 2 and it didn't go well - this is a more foundational piece I think.

Ok, now I'll say this. You could be rushing. How old is he? This is a process, the making of connections, his own personal journey of discovery. You can't force it with curriculum and you can't rush. you can nurture concepts and generalize. You're using the Interoception stuff, yes? So are you completely through phases 2 and 3? Have you read them? I think if you do the PToMG and phase 2 and 3 of the interoception stuff, you'll see things coming together. Where is his joint attention? That you hit with RDI, which you can also buy or find a provider for. We did an intake eval and got tasks. We need to do more, sigh.

If you're not noticing non-verbals, you're missing the input and feedback to realize how others are feeling and make better choices. That's the RDI piece. If you're missing interoception, you're not connecting their physical presentation to yours and realizing how they feel to make better choices. 

So those two things are both pivotal. To me, you cycle in and out of the ST materials overtly. They need that foundation so you can go push it some more.

3 hours ago, mamashark said:

Think Talk Laugh

Too hard. It's good, but it's targeted older. Again, no age in sig. How old is he? 7? Definitely way too young unless he has absolutely zero language issues. I like it, pick up a copy, but he's not ready now.

What's he doing with narrative language? How is his language showing up in his play? Have you expanded every unit/chapter in 100% Vocab and beaten that horse very dead? Can he make every single construction there expressively, independently?

Spotlight on Vocabulary Level 1: 6-Book Set

SPARC® for Attributes

SPARC® for Concepts

SPARC® for Grammar

We got HUGE gains from these. Of course look at the samples and see where your dc is. The SPARC series seems to simple, but it has them using everything independently in narratives by the end. My ds had a lot of memorized language, so it SEEMED like he was using language when he wasn't. Once skills were isolated, it was clear he couldn't use them. So SPARC starts off with words and builds the target into narratives by the end. Tons of work, really good work. 

Also I really like both the MW ASD set (which you held off on but would be ready for when you finish all your language work) and SKILL. You could learn a TON about the MW/SGM stuff just by reading their blog. I personally would put your $$ into language (narrative or concepts/vocab/syntax) over social thinking/Theory of Mind. You've already done the standards for a good foundation in social thinking, so it's more about generalization and the language holding him back.

[PeterPan]

With the Social Thinking stuff, you do the lessons then you apply and generalize the skills. We'll do sessions and then put him into situations to use them. Toggle a bit like that. Today I'm working on summer camp registrations for my ds. He can go to the Y camps by enrolling through their SN wing but attending the specialty/themed camps with a worker. At his age the worker ratios (1:10) aren't enough support. But for younger kids, those ratios go down. As long as the ratio gives enough support, he's good. 

Or what we've done in the past is social skills groups (3-4 workers for 10 kids) or things like going to the Y, playground, or playdates. Right now he wants me to organize a games club, same idea. So brief sessions to apply skills, done over and over. 

Remember, the key to make growth happen, is 1) the child knows his goal, 2) the child has a chance to practice working on it, and 3) the child gets feedback. That's your Ruth Aspy basics. So if he's in with kids but doesn't know the goal and isn't getting feedback, he's still not learning as much as he could. But it means you can make any situation stretch him if you set him up with goals and feedback and of course enough support that it goes well. 

[mamashark]

58 minutes ago, PeterPan said:

Ok, so I'll just laugh. I'm trying to read, but reality is most OT is floozy. Our current OT is less floozy and actually gets some results. But as far as being input/output, you spend money, things change, well... I'm pretty cynical. I drive 40 minutes each way to one, so I'm not too cynical. Just saying as a whole, it's the vaguest of therapy options.

Uh, theory of mind isn't the OT's gig anyway. They should be doing something concrete that falls in their territory.

This is what you're looking for. You'll LOVE it. Practical Theory of Mind Games

Ok, now I'll say this. You could be rushing. How old is he? This is a process, the making of connections, his own personal journey of discovery. You can't force it with curriculum and you can't rush. you can nurture concepts and generalize. You're using the Interoception stuff, yes? So are you completely through phases 2 and 3? Have you read them? I think if you do the PToMG and phase 2 and 3 of the interoception stuff, you'll see things coming together. Where is his joint attention? That you hit with RDI, which you can also buy or find a provider for. We did an intake eval and got tasks. We need to do more, sigh.

I'm sort of rushing but only in thought, not in practice. I know I need to take things slow in application, but knowing where I'm going, so that I can add things in as they fit, is what I'm trying to figure out. And the OT side-steps EVERY stinking question I ask her about order of skills, even concrete ones that should be in her territory. I have the interoception stuff and we're going through it SLOWLY. He needs it to be slow, to digest it and process it and apply it across situations. He was telling me how his feet felt today at the store as he paced while we waited in line. That's exactly what I'm looking for. And he's willing to do it, which is huge. I'll look at joint-attention to see what all that entails. He works for me pretty well at this point, because I am able to mirror his emotions really well and have done a good job at learning to validate him, and make things engaging. He's also really enjoying play therapy for quite some time now and has a great therapist working with him.

58 minutes ago, PeterPan said:

If you're not noticing non-verbals, you're missing the input and feedback to realize how others are feeling and make better choices. That's the RDI piece. If you're missing interoception, you're not connecting their physical presentation to yours and realizing how they feel to make better choices. 

So those two things are both pivotal. To me, you cycle in and out of the ST materials overtly. They need that foundation so you can go push it some more.

Too hard. It's good, but it's targeted older. Again, no age in sig. How old is he? 7? Definitely way too young unless he has absolutely zero language issues. I like it, pick up a copy, but he's not ready now.

What's he doing with narrative language? How is his language showing up in his play? Have you expanded every unit/chapter in 100% Vocab and beaten that horse very dead? Can he make every single construction there expressively, independently?

Spotlight on Vocabulary Level 1: 6-Book Set

SPARC® for Attributes

SPARC® for Concepts

SPARC® for Grammar

We got HUGE gains from these. Of course look at the samples and see where your dc is. The SPARC series seems to simple, but it has them using everything independently in narratives by the end. My ds had a lot of memorized language, so it SEEMED like he was using language when he wasn't. Once skills were isolated, it was clear he couldn't use them. So SPARC starts off with words and builds the target into narratives by the end. Tons of work, really good work. 

Also I really like both the MW ASD set (which you held off on but would be ready for when you finish all your language work) and SKILL. You could learn a TON about the MW/SGM stuff just by reading their blog. I personally would put your $$ into language (narrative or concepts/vocab/syntax) over social thinking/Theory of Mind. You've already done the standards for a good foundation in social thinking, so it's more about generalization and the language holding him back.

 

He's 6, but I don't think he has the same language deficits as your son, I'll see more maybe as I work through the 100% vocab. We've not fleshed out all the sections of it yet, again I don't want to rush it, and I want to ensure that he's understanding each concept. So far he's doing better with it (not struggling at all - finds the questions amusing) and my almost 8 year old DD who has dyslexia has to stop and think about the questions a little more. Ironically, I had to explain to my 3 year old son that he couldn't answer the questions for my daughter, as he would call out answers across the room while she was thinking. That boy is going to give me a run for my money.

I think the MW ASD set might need to be pretty high on my list, and with an unexpected change in our summer plans, some of our vacation money might be able to go towards it. My thought with the social thinking stuff was that I was told the fact that since he didn't seem to gain anything (except vocabulary) from the We Thinkers group, that he might need something more basic first, thus the Thinking about Me Thinking about You idea - that book was actually the recommendation given me as a more foundational piece that we might back up and do. And honestly, I'm finding splinter things to work on from Color my Conversation (like facial expressions), but in general it's too much for him right now since in practice, he's still unable to remember to say hello and goodbye without prompts.

Narrative language he's improved on - He recently was able to retell an entire paw patrol episode to me including characters and what they did and what the result was. He has to be in the mood to do it, though, and there's something I can't quite put my finger on yet that is still missing on his ability to simply narrate a story or event back to me, almost like he has trouble remembering, or dislikes the emotions that remembering brings up, or something. (so he can narrate back each thing he did in order at OT if he enjoyed it and left well-regulated. If he left disregulated due to an issue with transitions or something, then he won't be able to tell me anything they did no matter even after he's regulated again. 

His language in play is rich and he has gotten a lot more vocal lately. I'm seeing a lot more ideation, a lot more ability to direct the play and he's now able to communicate when he's not happy with how play goes. He can't always solve the problems, but he's able to communicate the problems now. AND, he got Stuck in the store today when I told him I couldn't buy him Batman, and he fought and cried and almost threw a big fit in the store over having to walk away, then I saw him stop, put his head down, and blow slow breaths out. I quietly told him he was doing a good job calming down and taking deep breaths and in amazing speed he had collected himself and was able to finish the shopping trip without issue. I was mentally trying to figure out how I was going to exit the store with him fighting me again and was so impressed that he was able to calm down. So that in itself was a huge win for me.

I guess the thing is, I just need to know what direction I need to head next, since I don't have the right level of professionals available to me at this point in time to work with him. I may use the OT for postural strength and fine motor skills. Just needed to know the best direction for the rest.

[mamashark]

Is it too spliced to get just the 6-second stories book from the MW set (which addresses one of the specific issues he has with language) and maybe It's All About the Story so I can have more resources to work with basic narration (I am about out of resources with Braidy on the stage 1 and 2 narrations) but not use Making connections? I like Practical Theory of he mind better than what I see of that on the website, and by piecing together what I want it would cost less...

[mamashark]

oh I'll also mention that I am always looking at stuff with dual purpose - my dd with dyslexia needs the language work, my DD 11 needs the social skill work. DD11 may be asd if we really pushed for a diagnosis, or maybe just gifted with social skill deficits, but she really needs the explicit stuff that my son needs, too. Things like, making smart guesses, she really struggles with. So that could be part of why you think I'm moving too fast, If something works on foundational skills for him, and hits goals for my other kids, it's more likely to catch my attention.

[PeterPan]

47 minutes ago, mamashark said:

my almost 8 year old DD who has dyslexia has to stop and think about the questions a little more.

Yes, there's a lot of discussion of comorbid language issues with dyslexia.

52 minutes ago, mamashark said:

in practice, he's still unable to remember to say hello and goodbye without prompts.

So are you parked on CMC1 or going on through all the lessons and frontloading?

58 minutes ago, mamashark said:

Narrative language he's improved on - He recently was able to retell an entire paw patrol episode to me including characters and what they did and what the result was. He has to be in the mood to do it, though, and there's something I can't quite put my finger on yet that is still missing on his ability to simply narrate a story or event back to me, almost like he has trouble remembering, or dislikes the emotions that remembering brings up, or something. (so he can narrate back each thing he did in order at OT if he enjoyed it and left well-regulated. If he left disregulated due to an issue with transitions or something, then he won't be able to tell me anything they did no matter even after he's regulated again. 

Good stuff! Yes, stress shuts down learning. Yes, MW/ASD is going to take him to the next level.

38 minutes ago, mamashark said:

Practical Theory of he mind better than what I see of that on the website, and by piecing together what I want it would cost less...

They're totally different things. The PToMG would hit him right where he is. My ds is on the older side, so even though the lessons were good (GREAT actually), we were doing like 3 a day, lol. But I super love it. 

I think I should just be really impractical and suggest things that are way too expensive. No seriously, if you want to work on narrative, work on narrative. You can go back to theory of mind stuff later. 

Link for those 6 second stories? I don't know why you need them. They have a graphic organizer but you might find it free. You could probably wing that. You've really had this mind meld with MW, where you seem to like their stuff, so continuing with what is working seems like a smart thing.

1 hour ago, mamashark said:

I just need to know what direction I need to head next,

this is the stuff I talk with our behaviorist about to get perspective. I would ask your play therapist. Ask flat up what is holding him back the most 

[mamashark]

2 minutes ago, PeterPan said:

So are you parked on CMC1 or going on through all the lessons and frontloading?

I have front-loaded a bit and had him play with the concepts with his siblings. He can do a lot more in the privacy of our living room with just our family than he can in practice in social settings. It's one of the benefits of having 4 kids. Might make me juggle more, but it gives me a built in social group.  

 

5 minutes ago, PeterPan said:

You've really had this mind meld with MW, where you seem to like their stuff, so continuing with what is working seems like a smart thing.

1 hour ago, mamashark said:

The thing I like about MW is the visuals. I find the manual (Braidy anyway) to be more complicated than it should be to implement, and takes a good bit of planning on my part, but I can't see anything showing me what SKILL looks like, so I'm having trouble knowing if it's something worth looking at for the cost. 

I will talk to the play therapist and see what she thinks. 

I think one thing I need to do is think about my intermediate goals. I have short term goals, but knowing what I want to achieve, what "there" looks like, will help me know better where I need to focus. 

[PeterPan]

The challenge is you don't have the pieces yet. I think getting MW ASD sounds like a logical next step for you. You can talk with them about the 1 book vs. set thing. I know people do that. The MW charts will show you how the language pieces go across the levels, which will then let you realize what you need to have happen in the play, narratives, etc. It will be cohesive, big picture. The theory of mind stuff is more just a piece.

When is national autism day? When that happens places usually run sales...

[PeterPan]

I'm not crazy. Autism month is April, so I would anticipate some sales. I think one year MW put their ASD kit on super awesome sale, like maybe 1/2 price. So maybe in two weeks your dreams can come true.   You can watch their FB or get on their email list to find out about sales.

Edited March 15, 2019 by PeterPan

[mamashark]

when you mention the mindwings charts, are you referring to the chart that shows the narrative levels?

That type of sale would be awesome! I'll not hold my breath for that much of a discount but any amount off would be helpful! I've already told my husband that I'll need at least $100 in the education fund for April. He rolled his eyes a little but said ok 😉 

[PeterPan]

There's a big appendix download that has pages for every step of the narrative development. They have test out rubrics for each level and they'll show what syntax, etc.

Maybe you can sell one thing to buy the next?

Edited March 15, 2019 by PeterPan