MAKING THE MOST OF YOUR TIME WITH

CHILDREN WITH SPECIAL NEEDS

Solana Beach School District

August 17, 2007

Joshua D. Feder MD, Child and Adolescent Psychiatrist

Faculty, Interdisciplinary Council on Developmental and Learning Disorders
Volunteer Faculty, Department of Psychiatry, UCSD School of Medicine

Abstract:

Getting the most with kids who have developmental and learning disorders:
How to engage in productive and rewarding interactions using a clear and easy to use
approach that is individualized, developmental, and relationship based. We will cover
the basics of helping kids be better regulated so that they are able to truly engage with us
and then interact with mutual communication where they learn by building on ideas
together with us. We will emphasize the importance of initiation and how to bring that
out and build on it, folding in goals for language, learning, and social growth.

First Hour:

DIR/Floortime®: The basics.

Calm enough - regulated

On the same page – engagement

True back and forth – social reciprocity

The Social-Emotional Growth Curve: Why is this so important?

It’s the basis for all true relating and learning.

Dual coding of emotion and learning

Emotional regulation and delayed gratification: learning, loving, and limits

Second Hour:

Step One: Taking your own pulse

How do you self regulate?

How do you engage with others?

What are your relationships like? Reciprocal?

Step Two: Learning your student

How does your student regulate? What works? What gets her off balance?

How does she engage? Can she be warm? And what are the boundaries?

What are her relationships like? Is there any reciprocity? When and how?

Step Three: Having fun

How can we help the child self regulate (without ever touching her).

How can we help anyone engage better and better over time.

What do we mean by making the relationship better? Is it more reciprocal?

Third Hour:

What about the IEP goals?

Project based learning – folding in all the goals.

Increasing symbolic complexity

Adults vs. peers

Reorganizing the goals

Will it work?

Persistance

Fun

Data tracking

Am I qualified?

Reading a book, or a pdf.

ICDL and related Certifications (DIRB, DIRC, FTP, PhD, Play Project)

Support and reflective tutoring is essential. – you need to be

actively thinking about what you are doing, paying attention to
your feelings, and getting help in sorting through it. There are
free resources in town, and there need to be mechanisms in
school to help out.

Conclusion: NOT ‘IF’, BUT ‘HOW’

The buck stops here: no choice – for parents, schools, and healthcare professionals

We cannot do it alone, but we can do it with support.

Resources:

Books:

Engaging Autism – Greenspan and Wieder

Playground Politics – Greenspan

Internet:

ICDL.com: lots of free information, including hours and hours of free podcasts – learn as
you drive to work!

ICDL Guidelines: 800 pages in 8 pdfs of free comprehensive information:

http://www.icdl.com/staging/bookstore/catalog/clinical.shtml

The Floortime Foundation: books, dvds, other resources

http://floortime.org/

Celebrate the Children: very practical information specific to schools

http://www.celebratethechildren.org/

Support Group:

Dr. Feder’s Free support group: Next meeting is September 5, 2007, at 415 North
Highway 101, Suite A, Solana Beach, CA, 92075.

Attachments:

1. Social Emotional Growth Chart

2. DIR® IEP Template

3. Sample DIR® tracking sheet

DIR® IEP TEMPLATE

XXXXX’s symptoms of his Autism Spectrum Disorder include problems with self
regulation, joint attention and social reciprocity which interfere with learning and with
everyday social emotional function. Fortunately XXXXX is quite able, with facilitation
and support, to be calm and regulated, and to work together in sharing and building ideas.
To accomplish this, I recommend that the I.E.P. team adopt the following social-
emotional goals that reflect in a straightforward manner XXXXX’s basic difficulties so
that these may be addressed:

1. Self-Regulation:
• Baseline: XXXXX is calm and focused __% of the time during any given 15
minute observation in class (“C”), __% during unstructured activities such as
recess and lunch (“US”).
• October 2005 Goal: __% C/ __% US.
• March 2006 Goal: __% C/ __% US
• June 2006 Goal: __% C/ __% US
• Responsible persons: teacher, staff, OT
• Suggested interventions and accommodations: OT consultation monthly, sensory
diet and strategies for home and school, staff facilitation of interactions with peers
including during unstructured times, typical ADHD accommodations.

2. Rigid Thinking/ Shared Attention:

• Baseline: XXXXX is on the ‘same page’ as others about __% of the time during a
given 15 minute observation in class (“C”) and about __% of the time during
unstructured time (“US”).
• October 2005 Goal: __% C/ __% US
• March 2006 Goal: __% C/ __% US
• June 2006 Goal: __% C/ __% US
• Responsible persons: teacher, staff, counselor (DIS)
• Suggested interventions and accommodations: social skills group, facilitation of
interactions in class and at lunch and on the playground, typical ADHD type
interventions such as non-verbal prompts.

3. Sharing Ideas/ Social Reciprocity:

• Baseline: XXXXX tends to focus in his own ideas in play and conversations, and
engages in actual mutual building of ideas about __% of the time during any
given 15 minute period while in class (“C”) and __% during unstructured time
(“US”).
• This can be assessed by examining a 15 minute sample of conversation and
scoring the percentage of times that XXXXX’s initiation or responses take into
 account and/ or respond to other people present. Tape recordings or videotape
may be needed to best assess this, although it can be done by observation as well.
I am happy of assist in the training of persons to do this.
• October 2005 Goal: __% C/ __% US.
• March 2006 Goal: __% C/ __% US
• June 2006 Goal: __% C/ __% US
• Responsible persons: teacher, staff, counselor (DIS).
• Suggested accommodations and interventions: social skills group, staff facilitation
in class, at lunch, and on the playground.

In summary, if we ask ourselves, in order, whether XXXXX is: a) calm and focused; b)
on the same page; and c) is he working with together with other people or more focused
on his own ideas, we will naturally be in position to facilitate XXXXX’s social-emotional
function. It is likely that his improvement will be easier in class, and with adults, but it is
truly critical that he improve.
DIR® DATA TRACKING SHEET – DRAFT

Name:

Date:

Time: In Class (am) Recess In Class again Lunch

Afternoon

Regulation
(calm
enough?)

Joint Attention
(on same page
as us?)

Social
Reciprocity
(true back and
forth?)

Fill in #minutes/15 min sample for tracking regulation and joint

attention

Use hash marks to count number of times child initiates or responds

appropriately for social reciprocity

Estimate % time for each goal at each time