@mekidsmom Moms do know best!! I know you are floating on Cloud 9 right now, and Katie is the big winner in all of it. Your pride in her accomplishments comes shining through in your post - but don't forget to pat yourself on the back at the same time! Is it my imagination or is that light bulb a whole lot brighter when it turns on over our kids' heads? And getting out of the Pull Ups is huge!! I can only dream of the day when we aren't using Good Nights on Kendra. This upcoming surgery will help with that!
This post is about to get very long,and I'm sorry but there's no other way to address a very good question.
@Calebs Chicks We didn't do much for "rewards" in the usual sense of the word. Oh, I know that people gush over the benefits of rewards, and what I'm about to say went contrary to what the girls' therapists and her mom thought as well. They like the traditional "rewards" thing but I have a different way of looking at it, and remember that I have NO professional expertise in the physiology and the psychology of Autism. But the way I look at it, we already know that our kids' brains are wired so differently than most. The point of all we do when we're working with them is to untangle those wires...to straighten them so they make the fastest possible connections with the least sidetracking and disruption. Does that make any sense?
Their wiring is more like a cluster of wires rather than orderly rows. So let's say I start giving Kendra a treat every time she does something well. That connection becomes the straight one - action.....response.....reward. And we do this over and over again with everything from looking into our eyes for 10 seconds longer than last time or overcoming a huge fear and moving forward. Well, then that day finally comes when they are out in the big world and they have to perform a task without a reward at the end. What happens to that nice neat connection? It's interrupted...it didn't go the way it has always gone. We either end up with a meltdown or a shutdown. They simply don't understand that a "nice job, Caleb" is sometimes as good as it's going to get, and there is no trip to McDonald's for their hard work. Non-autistic or non-mentally challenged kids can handle this transition because they weren't rewarded for absolutely everything they did. Sometimes there was a reward at the end, but most often times not. They understood early the personal satisfaction in a job well done, and were allowed to understand consequences for something they did wrong.
We tend to think that our special needs kids need more than our approval and a big hug, a shared smile, or all of the above, and in a many ways they do. What we found worked the best with Katie was her penny jars. Two pint Mason jars, one with a smiley face drawn on it and one with a sad face on it. She and I sat at the table and counted out 100 pennies. They went into a Zip lock bowl between the jars. Both were, of course, up on top of the fridge so she couldn't reach them and do any doctoring! Did she complete a tough project? Then we'd get her jar and the "bank" down and let her put a penny in. So far sounds like the typical rewards system, right? Well, here's the beauty of this one. She never knew when a penny would go into her good jar.
So if she was sitting on the floor coloring quietly, she'd suddenly hear "plink" and one of us would say something like, "With you being so nice and calm I was able to finish dishes." She wasn't called in from what she was doing, interrupting what her mind was focusing on. I used to just love to see the whole thing work. "Plink", look over and she'd still be doing what she had been doing, but with a new smile on her face. She wasn't TOLD to be good and stay out of the way so I could finish dishes....SHE chose to do that. No big fuss, no fanfare, none of that fol-de-rol. Just action...response....reward - but done our way. She learned that if she'd be a little patient I'd be finished with whatever I was doing and then it would be her time. And she learned to calm herself down!
Ever have Katie or Caleb decide she/he wants your undivided attention right NOW? Yeah, it can get so ugly that they GET that attention just to, well, frankly, shut them up. There, I said it! It's no less "normal" to get frustrated and want your disabled child to back off for ten minutes than it is for the mother of any other toddler or child to feel those things. But we're made to feel guilty because our little one is "special" and we took off the kid gloves for a minute or two. Well, maybe so, but living in a family and then going out into society requires us to teach them at least some control. That's what the penny jar does. Out of control behavior? First we'd look for an actual reason....step on a Lego? Break a crayon? That kind of thing. If the problem could be solved without giving in to the tantrum, calmly and quickly, we could then remind her that we don't mind helping her but she needs to ask and sometimes wait a minute. And we'd wait to fix that problem until she either asked or indicated what she needed. But Katie was also very skilled in suddenly breaking into this God-awful screech, flapping and rocking rather than telling us what was wrong. Most often nothing was wrong - her brain was just firing in response to some stimuli we couldn't pick up on.
So we gave her some other stimuli to focus on. We'd get down the "Oops" penny jar, and wait for that lull where she'd have to take a breath. In that moment, right where she could hear or see us, a penny went into the "Oops' jar. (We NEVER called it the "sad jar" or the "bad jar", mind you.) At first I was discouraged. It didn't seem to stop anything. I swore sometimes she'd act out just to see us go through the hassle of getting it down and putting that penny in because the focus, negative or not, was still on her. But we knew she got it when she'd hear the jar shake and she'd struggle to get herself under control before a penny went in. By the way, even if she did regain control, the penny went in. She had to learn that the behavior should never have happened in the first place and there were consequences. But as soon as she was under control, she saw us put a penny in the good jar. And they don't have to be able to talk for this system to work. Katie didn't start talking until she was a little over 3 years old, and by then the pennies were already in play.
So what makes this different? Because at the end of the time when the Ziplock container bank was out of pennies, we didn't take her for an ice cream or let her buy a toy with the money. We had another, bigger bank. She got to count and then put all those pennies from her good jar into her big bank at the end of the time. In the beginning, while she got the hang of it and we learned to be consistent, we let her put them in at the end of each week. Took about 3 weeks and we were able to back it off to 2 weeks, did that a couple of times, then it was a month. But whenever we did the pennies, we let her take all the pennies from the "oops" jar and put them back in the ziplock. I was stunned how fast she figured out that the pennies for good behavior she could keep forever, but the pennies in the "Oops" jar were just because she made a little mistake and she could always start over with them. THAT was key - she could always start fresh! We never did do anything as a reward with those pennies. Instead though the years we've added to the big bank, just change here and there, sometimes a dollar or two, but now that bank has nothing to do with Katie's behavior. It's just there - something that we all dump change into. I don't know yet what we'll do with it all....it's pretty doggone full at this point, but you can bet it'll be something for the grandkids - all of them. And Katie will have made another contribution to the well being of the family.
Will this work with Caleb and Katie? Quite simply, I don't know. We started doing this when Katie still wasn't talking or focusing on us much, so it wasn't a rousing success in the beginning. It took us all some time. She had to learn what it meant - if she helped Gramma or managed to complete a task, she got a good penny. If she was just being calm and quiet, she'd get a good penny. Just not all the time....that was more a discretionary thing on my part. But meltdowns, tantrums, refusing to cooperate...those were "oopses". We had to learn to be consistent even when it looked like we were getting nowhere. We also had to learn to take it outside the home. I'd stick 2 or 3 of "her" pennies in my pocket. When we got to where we going, I'd crouch to her level and remind her that I had her pennies in my pocket and if she was good in the store or wherever I'd let her take them out of my pocket and put them in her jar when we got home. I'd give her a warning, "There will be no whining, no crying, and no pouting in here." Then we'd go in. If she looked like she was going to get off track, I'd jingle those pennies and give her a little frown. If she was being very good, I'd also jingle the pennies but with a big smile on my face.
Sadly Katie's mom has a different idea of what constitutes "rewards"....hence Katie now weighing 140 pounds at 10 years old. She couldn't stick to the penny thing and turned back to what she knew as a child...sweets if you're sad will cheer you up, if you got an "A" it would be your reward, if you're mad here, have a candy bar and calm down. Yeah, and without understanding that food can be more of a comfort thing to kids with autism, like head banging or flapping, simply because it's another sense that the child can use to override over-stimulation in the environment, I'm afraid that will forever be Katie's "norm". It's not the taste or the tummy satisfaction that makes food rewards so harmful (in my opinion, mind you) to the long term success of our kids, it's the oral comfort. Remember that in the beginning of Katie's life I had her here from 8 in the morning until 7:30 at night, 6 days a week, so I had the opportunity to fully implement the penny system and keep it going.
Right now we haven't found anything that has worked with Kendra, but her issues are so much deeper than Katie's high functioning autism. I'd be lying to say otherwise. We know she likes M&Ms but that trap scares me given Katie's weight issues. We have to pick Kendra up and carry her so much it would kill us all, not to mention her use of the wheelchair. So far she responds well to just putting our hands on her head or upper arm and applying GENTLE pressure, not rubbing or stroking but just holding it there. That calms her down quickly, whereas any kind of massaging seems to push her further away. So besides lots of hugs and verbal praise, we haven't found that magic key yet.
I don't know if this helps you or not. Caleb is not Katie and his issues are totally different, as are @mekidsmom issues with her Katie. But you asked what I did for rewards, and I wanted to make it clear how I feel about straightening those wire connections and how I feel about rewards for our kids that use just another physical sense (taste) to elicit desired behaviors. I firmly believe they do more harm than good. And I'll bet you'll find that when you pull him out of school and can have full time control of how much stimulation he gets over the course of a day, he will begin to sense when he's close to his breaking point and you'll recognize it right away too, allowing you to start the calming process before he gets too far into himself.
Okay, off my soapbox now. Whew!!