Help, please! autistic student refuses transitions

Discussion in 'Special Education Archives' started by shwal, Sep 16, 2006.

  1. shwal

    shwal Rookie

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    Sep 16, 2006

    I just finished the fifth week of school with a brand new class of 6 autistic students (ages 5 to 7.) One boy is often having major meltdowns during transitions. Sometimes they occur on the way to a less preferred activity, but most of the time that is not the trigger. He has his hand held by one of us (me or one of two paras) whenever we leave the classroom as he has a serious history of being "a runner." He will pull away and drop to the floor, making loud, angry noises. He is very strong and we can't physically keep him on his feet. Once on the ground, he becomes louder and more agitated. If we try to get him to stand, he just resists harder/louder. When we have to move him due to the setting (in another classes' way in the bathroom, will miss the bus if we don't, etc.) it takes two of us and even then is very difficult. That leaves one adult for the others, who then often become unmanageable.

    Twice so far I have gotten hurt (swelling where I had abdominal surgery a few years ago, from lifting him to walk.) If we do not try to move him he has a few times gotten back up and walked with us. But several times recently this has not been successful. He has tantrummed for prolonged periods, gotten up, taken a step or two in an attempt to run, then fallen back down when running was prevented and resumed even more agitated, long tantrums.

    The most recent cases have been on the way to activities he likes (lunch, going home.) so it doesn't seem like escape/avoidance issues. He gets teacher attention, but especially when we are out of the classroom, it is sometimes impossible to avoid. I was told by last year's teacher that as long as he had transition pictures, he was okay. We have provided pictures and food rewards for "good walking" for the last three weeks or so. They seemed to help for a few days, but not after the novelty wore off.

    I have had many young autistic students with these types of behaviors in the past, but I can't seem to find a way to help this child. I would appreciate ideas/advice.
     
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  3. ellen_a

    ellen_a Groupie

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    Sep 16, 2006

    Have you tried giving him something to carry? I know some students who transition much better if carrying a basket of items or some who transition when wearing a weighted backpack. Are you providing a highly reinforciing item (edibles) really frequently while walking, not as an end reinforcer when you reach your location (i.e. every 2 steps or so, provide a small edible?).

    I also know some students who transition with a wheelchair--they do not need the support, but the wheelchair keeps them "compliant." This is a "end-of-the-road" modification, and would probably need some approvals from various people (administration, parents, etc.) and probably shouldn't be used all the time (if it is used) so the students will not become compliant. But if you had a documented pattern of concerns (i.e. 95% of the time, this student tantrums on the way to the cafteria) you might try using a wheelchair at only that time.

    I absolutely would not pick him up or physically move him--this isn't safe for him or you. I would wait him out, tell other classes to go around, etc. He may find your physical intervention reinforcing. Can one person safely restrain him if he does get up and run (i.e. hold in a standing or seated wrap)? If that is the case, I would have one individual (probably myself) stay with him and wait him out, and the other two staff proceed with the others as normal.

    Just my thoughts. :D
     
  4. krisaustin

    krisaustin Companion

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    Sep 16, 2006

    Have you tried picture schedules to help the student know what comes next in his or her day?

    I have a student with autism who is transitioning fine but while in class (mine or the gen. ed.) is doing inappropriate behaivors (bitting herself and screaming), we are documenting all of this and trying to determine a sensory diet for her. She is a very sensory person.
     
  5. shwal

    shwal Rookie

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    Sep 16, 2006

    Thanks for your quick reply. Yes, we are providing the edibles every few feet. I have tried having him carry something but when he gets upset he just drops it-I will try again. I wish it was always possible to just let him stay where he is, I think that would work best, but in the recent instances I cited it just has not been. Once was in the very narrow bathroom while two other classes were waiting to get in. We had already held things up for quite a while and had to get out-long story short-the entire school has only one girls' and one boys' bathroom and classes must take turns. We are in an all special ed school so letting him remain there screaming and kicking would be too disruptive to the other special needs students (he goes on even longer if he has an audience.) The last time was on the way to the bus-we had to get him to the bus to go home.

    When he really gets going, one person can't hold him in a seated or standing hold (attempting to is part of what caused my swelling, not only having to move him.) I've done lots of restraint over the years, but this child is remarkably strong.

    I doubt I could get permission to do the wheelchair, maybe that could be a last resort.
     
  6. shwal

    shwal Rookie

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    Sep 16, 2006

    Yes, we are using picture schedule and the transition picture to hold suggested by the last teacher. I just feel stumped-I know a lot of the problem is our setting, but those issues I can't change.
     
  7. ellen_a

    ellen_a Groupie

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    Sep 16, 2006

    How about one of those ropes they use for little ones to walk with? Just think it gives him something more concrete, its a long shot.

    What sort of picture/transition schedule is he using? Line drawings or photographs? Are you SURE he understands it? Is there something that he wants when you see him drop? Have you tried giving him a choice menu when he drops to find out if he wants something--is there a specific reason he's dropping? How are you prompting him to get back up--verbals, visuals, what?

    I'm stumped too, wish I could be of more help!
     
  8. ellen_a

    ellen_a Groupie

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    Sep 16, 2006

    One more thing, sort of like the carrying a basket, I've had a few kids who will PUSH a wheelchair better than they will walk independently--it keeps them focused on a task. Maybe that might work? Or pushing/pulling something else? Let me think some more, maybe I'll have a lightbulb moment.
     
  9. shwal

    shwal Rookie

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    Sep 16, 2006

    I've that experience too-kids doing better pushing a wheelchair-but none of our students use one. Our room is so small that it would take up pretty valuable real estate to store one just for that. Making the whole thing more stressful: his parents don't seem to be aware of this having been a problem for him in past years (although I've talked to a consultant who says he's had this problem since he's been in school.) Apparently it was not brought to their attention or maybe because he was not as big/strong it was not as much of an issue. So now it's appearing as if it's our fault he's having so much trouble.

    Thanks for helping me think this throughI; just knowing that you care enough to try makes me feel better. I'm getting no support from all our system's "experts" who troop through my room. This is one of a dozen unusually difficult situations going on with my class this year that are pushing me over the edge (but it's the only one with my kids); the others are with the adults and the unbelievably time-consuming aba paperwork. I feel like I'm not going to make it through the year, I'm so exhausted from the 14 hour days and working most of the weekend, only to fall farther behind. I have 25 + years of successful teaching experience but now I feel incompetent.
     
  10. minniemouse

    minniemouse Rookie

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    Sep 18, 2006

    One of my autistic girls has a special bookbag on wheels that I fill with books that she can pull along with her if needed. Have you tried a weighted vest? Autistic kids like that kind of pressure. Also, have you tried social stories with him? I've had a lot of luck with that (as the other teachers I work with). They are easy to write and they can be jotted down quickly right there in the hallway. Then you can go back later with him and type it out on a special program that puts pictures along with the words. We have two programs that we use, one is Boardmaker and the other is called Pixwriter (I think). I prefer the Pixwriter. Hope this helps!
     
  11. clarnet73

    clarnet73 Moderator

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    Sep 18, 2006

    I kept a wagon outside my door last year that had full water jugs in it. My runners or other kids that needed heavy work pulled it (or pulled another student in it!) when they went somewhere. My kids LOVED having it as a "job."
     
  12. Mrs_Barrett

    Mrs_Barrett Cohort

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    Sep 23, 2006

    Do you do any type of schedule and work system. Does he have a home base? Give him a short activity that he enjoys and then transition him. Are you giving him visual cues that you are about transition?
     
  13. sva

    sva Rookie

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    Sep 23, 2006

    Sometimes pushing a weighted toy stroller or toy shopping cart provides some sensory input.

    Does the child carry the transition picture to the location? Have you tried an object schedule?

    I know your frustration. Just be careful with the physical restraint, even just holding him, without another adult present. Unfortunately we need to consider possible litigation in any questionable situation.
     

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