Saturday, September 1, 2012

There is no such thing as a dumb question!

So why do we ask questions?  We ask questions because we want to know the answer… to something that we are trying to understand,  or we want to know the other persons perspective of whom we asked the question in the first place .  We do this, because we want to accumulate knowledge and learn.  I know for me,  Ill ask a question to save time too…like , Hey where are the keys?  That way I don’t have to spend time looking for them.  That is accumulating knowledge that someone else has for our own benefit.  Or, do you like the chicken or the fish?  I want to know the persons *perspective* that I am with to help me with my decision.

Enter Autism ( into the picture)… and questions can work abit differently.  Children with ASD can ask questions over and over again because of anxiety over a future event.   With my oldest son,  his use of questions was for a  purpose related to anxiety, but more complex.   He asked me questions all day because he wanted to feel competent that he knew where the conversation was going…in other words,  he removed all uncertainty in our conversation so that he could feel safe when he talked to me.  He asked me questions that he knew the answer too.  The interaction went something like this…  He would ask me a question, then I would try and answer him and if I did not answer him the exact way he was thinking I would,  he would then answer the question after I answered the question.  This of course meant that he knew the answer to the question before he asked me. Needless to say,  in no short time this drove me insane as I answered questions all day only to realize he already knew the answer.

I remember saying to his therapists ( This started around 6 years old )….MAKE HIM STOP! Lol  and we tried many different behavioral strategies.  It was not until he was around 9 that developmentally he was able to feel safe in the uncertainty of a *open ended conversation*.  We had been doing RDI with him for over a year at this point to help him get there.

A strategy that worked for us… I would ask him, Oh you know the answer to this!  Then I would say, so I love that you talk to me…anything you say ( decreases anxiety) and it sounds like you are trying to tell me something …Here is how you tell me something without asking a question ( and still knowing that the outcome is the same)  Then I told him how to reword the question into a *Mom, quess what* statement… Meaning to open it up like, quess what ( and then tell me instead of ask me).  This helped him to then be ok with my *answer* too, as he started to enjoy the back and forth and be resilient in not having to know the answer.  There are many different strategies hooked into this, this is just the beginning one.  However, within my own sons RDI program, I recognized at the same time we really needed to address this at its core too.  He was asking me questions because he so wanted to be successful with me in an interaction…and for him, asking the question and me answering was SUCCESS.  So who would not want to repeat success…right???  We do all the time…when we go out with a friend, etc and we have a great time,  one of the first things we say is..lets do that again!  We know though that it’s the relationship that we want to *do* again,  not the exact events and actions of the time spent. 

If your child is asking questions that he knows the answer too, try the strategy above.  In addition, here are a few beginning tips to work on a few of the core deficits of Autism- dynamic analysis, experience communication, and  Episodic memory.  Addressing competence and resilience from the ground up is crucial to help your child understand thoroughly the WHY of communcation.

Working on Dynamic Analysis-   Our kids need help knowing the important part of the interaction.  Instead of paying attention to the *answer*, focus more on the relationship ( I love when we talk to each other or I love your smile!)  Your child hears your thoughts that you are paying attention to more than just their question.  At first there may be some anxiety over you not answering them right away, but you are giving them the opportunity to process your perspective ( you have their attention as they wait for what they *want* to hear).  You can follow this up with commenting to them a great way to tell *Mom* something is hey Mom…_____________,

Working on Experience sharing communication-  When your child asks you a question that they know the answer too, use non verbals to answer them and then pair the non verbal communication with a strategic pace of any comment you make ( for Dynamic analysis). Strategic pace is pausing at the moment that is important …to highlight and say to your child…here…this is important to pay attention too!

Working on Episodic memory- look for opportunities when helping your child feel secure in his communication to reflect on past experiences of the subject that he is asking about.  Recalling past events, reviewing success and reminiscing about joint shared experiences will help your child’s motivation to want to continue to build a conversation with you,  even when he is unsure of the outcome ( an open ended conversation).  This is a great time to talk about your emotions and /or your childs emotions as a reflective process.  This helps your child see that communication is a reflective process built on experiences,  and is truly a back and forth interaction where the uncertainty is an interesting aspect of a conversation and not something to produce anxiety.
 
For more on RDI www.whatisrdi.blogspot.com

 

 

ese children need to constantly know what is coming up to feel secure. Questioning becomes a way of making the world more clear, consistent, and predictable.

2. Some children experience anticipatory anxiety (strong excitement about what is coming up) and will continually question as a way of coping with anticipation.

3. Some children who want attention will repeatedly ask the same question as a way of interacting, getting attention. This occurs especially if they either do not know how to get attention in other more appropriate ways, or if the intensity of reaction they get from questioning is much stronger then what they get for appropriately initiating interaction.

ese children need to constantly know what is coming up to feel secure. Questioning becomes a way of making the world more clear, consistent, and predictable.

2. Some children experience anticipatory anxiety (strong excitement about what is coming up) and will continually question as a way of coping with anticipation.

3. Some children who want attention will repeatedly ask the same question as a way of interacting, getting attention. This occurs especially if they either do not know how to get attention in other more appropriate ways, or if the intensity of reaction they get from questioning is much stronger then what they get for appropriately initiating interaction.

There are a few behavioral techniques that have worked successfully for me with several children I have worked with in the past:

1. Answering the child once when they repeat a question, then telling them that is the last time they will answer. From then on in, the parent gives no verbal response. They may shake their head no, but not give a verbal answer. In all cases, the parent’s verbal answer is what reinforces the child to ask again. This is discussed with the child ahead of time, so he knows the parent will not verbally answer anymore. This would probably cause increased problems for Robert.

2. For some children answering only once is not enough, so you might try answering no more than three times. Then with each answer you count them off. When you hit three that is it.

3. Some children will inhibit the response if you repeat the question to them. So the second time they ask the question, “Are we going to McDonalds for dinner?”, you say “Bobby, are we going to McDonalds for dinner?” They will usually give you the answer, and stop repeating the question.

4. For an older teen, who could read and write, we would answer the repeated question one time, then have him write down the answer and carry it with him. If he asked again, the parent would refer him to his note. Another technique that has worked is writing the answer down on a note board and referring the child to that board. This worked well, since the verbal response is what reinforces the repeated questioning.

5. This next technique is for children who find it real difficult to stop, so we gradually decrease the behavior as the child becomes more controlled in refraining from questioning. It is more complex but has worked well.

a. The parent keeps track, for a couple of days, of how frequently the child repeatedly questions during the day (let’s say an average of six times a day) and how many repetitions of a question the child averages (let’s say five repetitions of a question). Then from there we write a plan to start gradually decreasing those frequencies (the number of repetitions of each question, and the number of times a day repeated questioning occurs.

b. To decrease the number of repetitions child gives per question, if the average frequency is five, we would start by answering the child up to four times. We would tell the child that we can only give up to four responses. Each time the child repeated the question, the parent responds “this is number one” and answers the question. Then each response starts with “this in number 2, 3 or 4” and answers the question. At the forth time the parent reminds the child they cannot answer it again. If the child stops asking, the parent will praise the child, “Sally, you really please mommy by not questioning after I told you no”. If the child asked again, the parent shakes her head no, and gives the child the manual sign for “no”. The parent does not give another “verbal answer” to the question, regardless of how intense the child gets. When the child gets used to asking only up to four times, then we decrease to three times. We gradually decrease to twice and only once.

c. Now, we want to reward the child for stopping at the predetermined number of repetitions, as well as decrease the number of repeated questionings throughout the day. In this example, the child averages repeated questioning six times a day. We start at that number. We make a laminated chart with six boxes on it. We also post a picture of a few rewards that the child can earn next to the board. For each time the child engages in repeated questioning, when he doesn’t stop at four, the parent puts a cross, or frown face, in one of the boxes (with an erasable marker). The parent tells the child that if there is at least one box left by a certain time of the evening, the child will get their choice of one of the rewards. So, in this case, if the child has four or less times when he doesn’t stop repeated questioning, he will earn a reward. This way, we start with were the child is at, teach him how to earn the reward, and then slowly started reducing the number of boxes (chances) he has to earn the reward. So for step b above, when the child asks for the fifth time, the mother shakes her head no, gives manual sign for “no”, and walks over and crosses out one of the squares. If the child has at least one box left by the evening, he gets his choice of reward. If he has all five boxes crossed off, parent shows him, tells him he cannot get the reward tonight, but he can try again tomorrow.

Another way you can work this, is using the same style board, give the child a star in each box each time he stops the questioning at the predetermined amount without going over. So, if the child stops at four repetitions, the parent praises him, and gives him a star to put on his chart. Once he earns the right number of stars he earns a reward.

6. Another technique is to answer the child once or twice. Then the next time the child asks, you tell him you will not answer that question again, and ask him a simple question to redirect him. This way you are redirecting him to talk about something else. If he doesn’t answer, but asks his question instead, you continue to ignore his question and continue to ask him your question until he answers. If he answers your question and goes back to his, you simply ask another question about the issue you want to talk about and keep focusing on what you are asking him. Eventually they learn to take the redirection and converse on what you want to talk about.

Remember almost all of the techniques focuses on 1) stop rewarding his repeated questioning with “verbal answers” and 2) focusing (rewarding) him for responding the way you want him to do.

ese children need to constantly know what is coming up to feel secure. Questioning becomes a way of making the world more clear, consistent, and predictable.

2. Some children experience anticipatory anxiety (strong excitement about what is coming up) and will continually question as a way of coping with anticipation.

3. Some children who want attention will repeatedly ask the same question as a way of interacting, getting attention. This occurs especially if they either do not know how to get attention in other more appropriate ways, or if the intensity of reaction they get from questioning is much stronger then what they get for appropriately initiating interaction.

There are a few behavioral techniques that have worked successfully for me with several children I have worked with in the past:

1. Answering the child once when they repeat a question, then telling them that is the last time they will answer. From then on in, the parent gives no verbal response. They may shake their head no, but not give a verbal answer. In all cases, the parent’s verbal answer is what reinforces the child to ask again. This is discussed with the child ahead of time, so he knows the parent will not verbally answer anymore. This would probably cause increased problems for Robert.

2. For some children answering only once is not enough, so you might try answering no more than three times. Then with each answer you count them off. When you hit three that is it.

3. Some children will inhibit the response if you repeat the question to them. So the second time they ask the question, “Are we going to McDonalds for dinner?”, you say “Bobby, are we going to McDonalds for dinner?” They will usually give you the answer, and stop repeating the question.

4. For an older teen, who could read and write, we would answer the repeated question one time, then have him write down the answer and carry it with him. If he asked again, the parent would refer him to his note. Another technique that has worked is writing the answer down on a note board and referring the child to that board. This worked well, since the verbal response is what reinforces the repeated questioning.

5. This next technique is for children who find it real difficult to stop, so we gradually decrease the behavior as the child becomes more controlled in refraining from questioning. It is more complex but has worked well.

a. The parent keeps track, for a couple of days, of how frequently the child repeatedly questions during the day (let’s say an average of six times a day) and how many repetitions of a question the child averages (let’s say five repetitions of a question). Then from there we write a plan to start gradually decreasing those frequencies (the number of repetitions of each question, and the number of times a day repeated questioning occurs.

b. To decrease the number of repetitions child gives per question, if the average frequency is five, we would start by answering the child up to four times. We would tell the child that we can only give up to four responses. Each time the child repeated the question, the parent responds “this is number one” and answers the question. Then each response starts with “this in number 2, 3 or 4” and answers the question. At the forth time the parent reminds the child they cannot answer it again. If the child stops asking, the parent will praise the child, “Sally, you really please mommy by not questioning after I told you no”. If the child asked again, the parent shakes her head no, and gives the child the manual sign for “no”. The parent does not give another “verbal answer” to the question, regardless of how intense the child gets. When the child gets used to asking only up to four times, then we decrease to three times. We gradually decrease to twice and only once.

c. Now, we want to reward the child for stopping at the predetermined number of repetitions, as well as decrease the number of repeated questionings throughout the day. In this example, the child averages repeated questioning six times a day. We start at that number. We make a laminated chart with six boxes on it. We also post a picture of a few rewards that the child can earn next to the board. For each time the child engages in repeated questioning, when he doesn’t stop at four, the parent puts a cross, or frown face, in one of the boxes (with an erasable marker). The parent tells the child that if there is at least one box left by a certain time of the evening, the child will get their choice of one of the rewards. So, in this case, if the child has four or less times when he doesn’t stop repeated questioning, he will earn a reward. This way, we start with were the child is at, teach him how to earn the reward, and then slowly started reducing the number of boxes (chances) he has to earn the reward. So for step b above, when the child asks for the fifth time, the mother shakes her head no, gives manual sign for “no”, and walks over and crosses out one of the squares. If the child has at least one box left by the evening, he gets his choice of reward. If he has all five boxes crossed off, parent shows him, tells him he cannot get the reward tonight, but he can try again tomorrow.

Another way you can work this, is using the same style board, give the child a star in each box each time he stops the questioning at the predetermined amount without going over. So, if the child stops at four repetitions, the parent praises him, and gives him a star to put on his chart. Once he earns the right number of stars he earns a reward.

6. Another technique is to answer the child once or twice. Then the next time the child asks, you tell him you will not answer that question again, and ask him a simple question to redirect him. This way you are redirecting him to talk about something else. If he doesn’t answer, but asks his question instead, you continue to ignore his question and continue to ask him your question until he answers. If he answers your question and goes back to his, you simply ask another question about the issue you want to talk about and keep focusing on what you are asking him. Eventually they learn to take the redirection and converse on what you want to talk about.

Remember almost all of the techniques focuses on 1) stop rewarding his repeated questioning with “verbal answers” and 2) focusing (rewarding) him for responding the way you want him to do.

ese children need to constantly know what is coming up to feel secure. Questioning becomes a way of making the world more clear, consistent, and predictable.

2. Some children experience anticipatory anxiety (strong excitement about what is coming up) and will continually question as a way of coping with anticipation.

3. Some children who want attention will repeatedly ask the same question as a way of interacting, getting attention. This occurs especially if they either do not know how to get attention in other more appropriate ways, or if the intensity of reaction they get from questioning is much stronger then what they get for appropriately initiating interaction.

There are a few behavioral techniques that have worked successfully for me with several children I have worked with in the past:

1. Answering the child once when they repeat a question, then telling them that is the last time they will answer. From then on in, the parent gives no verbal response. They may shake their head no, but not give a verbal answer. In all cases, the parent’s verbal answer is what reinforces the child to ask again. This is discussed with the child ahead of time, so he knows the parent will not verbally answer anymore. This would probably cause increased problems for Robert.

2. For some children answering only once is not enough, so you might try answering no more than three times. Then with each answer you count them off. When you hit three that is it.

3. Some children will inhibit the response if you repeat the question to them. So the second time they ask the question, “Are we going to McDonalds for dinner?”, you say “Bobby, are we going to McDonalds for dinner?” They will usually give you the answer, and stop repeating the question.

4. For an older teen, who could read and write, we would answer the repeated question one time, then have him write down the answer and carry it with him. If he asked again, the parent would refer him to his note. Another technique that has worked is writing the answer down on a note board and referring the child to that board. This worked well, since the verbal response is what reinforces the repeated questioning.

5. This next technique is for children who find it real difficult to stop, so we gradually decrease the behavior as the child becomes more controlled in refraining from questioning. It is more complex but has worked well.

a. The parent keeps track, for a couple of days, of how frequently the child repeatedly questions during the day (let’s say an average of six times a day) and how many repetitions of a question the child averages (let’s say five repetitions of a question). Then from there we write a plan to start gradually decreasing those frequencies (the number of repetitions of each question, and the number of times a day repeated questioning occurs.

b. To decrease the number of repetitions child gives per question, if the average frequency is five, we would start by answering the child up to four times. We would tell the child that we can only give up to four responses. Each time the child repeated the question, the parent responds “this is number one” and answers the question. Then each response starts with “this in number 2, 3 or 4” and answers the question. At the forth time the parent reminds the child they cannot answer it again. If the child stops asking, the parent will praise the child, “Sally, you really please mommy by not questioning after I told you no”. If the child asked again, the parent shakes her head no, and gives the child the manual sign for “no”. The parent does not give another “verbal answer” to the question, regardless of how intense the child gets. When the child gets used to asking only up to four times, then we decrease to three times. We gradually decrease to twice and only once.

c. Now, we want to reward the child for stopping at the predetermined number of repetitions, as well as decrease the number of repeated questionings throughout the day. In this example, the child averages repeated questioning six times a day. We start at that number. We make a laminated chart with six boxes on it. We also post a picture of a few rewards that the child can earn next to the board. For each time the child engages in repeated questioning, when he doesn’t stop at four, the parent puts a cross, or frown face, in one of the boxes (with an erasable marker). The parent tells the child that if there is at least one box left by a certain time of the evening, the child will get their choice of one of the rewards. So, in this case, if the child has four or less times when he doesn’t stop repeated questioning, he will earn a reward. This way, we start with were the child is at, teach him how to earn the reward, and then slowly started reducing the number of boxes (chances) he has to earn the reward. So for step b above, when the child asks for the fifth time, the mother shakes her head no, gives manual sign for “no”, and walks over and crosses out one of the squares. If the child has at least one box left by the evening, he gets his choice of reward. If he has all five boxes crossed off, parent shows him, tells him he cannot get the reward tonight, but he can try again tomorrow.

Another way you can work this, is using the same style board, give the child a star in each box each time he stops the questioning at the predetermined amount without going over. So, if the child stops at four repetitions, the parent praises him, and gives him a star to put on his chart. Once he earns the right number of stars he earns a reward.

6. Another technique is to answer the child once or twice. Then the next time the child asks, you tell him you will not answer that question again, and ask him a simple question to redirect him. This way you are redirecting him to talk about something else. If he doesn’t answer, but asks his question instead, you continue to ignore his question and continue to ask him your question until he answers. If he answers your question and goes back to his, you simply ask another question about the issue you want to talk about and keep focusing on what you are asking him. Eventually they learn to take the redirection and converse on what you want to talk about.

Remember almost all of the techniques focuses on 1) stop rewarding his repeated questioning with “verbal answers” and 2) focusing (rewarding) him for responding the way you want him to do.