During the summer of 2009, I participated in an internship opportunity provided through Summit Education called “Connections.” This was a cognitive-behavioral therapy camp for children between the ages of 7-13 who were diagnosed with Aspergers Disorder. In this camp they were taught social skills through empirically based procedures. The program lasted 6 weeks, one week which was allocated at the beginning as a training week for the counselors, the five following weeks for the summer camp, and then two days after the camp ended for the organization and processing of data.
I had previously been briefed by Dr. Putnam about what I could expect from this experience: long hours, stressful days of working with children who had mental deficits, but also of the great reward counselors experienced at the end of the program. Thus I began my training week with mixed feelings. I was nervous yet excited to begin the process. At a previous meeting, all counselors had been provided a copy of the manual of the program that they were to have memorized by the beginning of the program. This included the DSM-IV description of Aspergres and Autism, a detailed outline of their procedure for teaching the social skills (a nine-step process called “Skillstreaming”), and the various behaviors that would be assigned either negative or positive point values. Tension surrounding the first day of training surrounded this manual as all counselors were required to pass a test on the manual with a 100%. If you did not, you would be unable to participate in the program.
That first day, everyone arrived at 8am in the morning and immediately we took the test on our knowledge of the manuel. After two weeks of constant studying and memorization, it is a relief to see what has been asked on the exam. We had been told to memorize verbatim the different behaviors definitions and their point values, the clinical definition of Aspergers, along with the order of the skillstreaming steps and their operational definitions. Within the program, behaviors were altered through rewards in the form of points. These points were called out by counselors as they happened and tallied on a score sheet. At the end of each day these pointed were counted and recorded in a master file that calculated their totals for each day and a weekly total. These weekly totals were used to determine whether or not the children had earned the right to go on the week’s end fieldtrip.
After taking the exam, we were assigned to our three person “teams.” My team consisted of Danielle Schmidt who I had previously known through Canisius, and Ashley Warhol, who had participated in the program for 3 years prior but who could not attend training week due to class scheduling conflicts. This placed an added stress on Danielle and me as we were unable to bond and get to know our team leader before we started the program. After the test was finished and an introduction had been made by Dr. Thomeer and Dr. Lapata, the counselors began to practice “skillstreaming.”
This was to be the bulk of what we did through training week. Three people would work together as a “team”, with only one actually leading the skillstreaming, and then six other counselors would volunteer to act as the children; the remaining counselors would watch the role-play. The first few counselors who led a mock skillstreaming session were veterans who had previously been through the program. It was very intimidating for the first year counselors as the cadence in which they went through the steps and their level of engagement with the “children” was very fast and intense. Each skillstreaming session is to be exactly 20 minutes in length, a feat which at times is difficult to achieve. Along with the time limitations it is critical for counselors to be engaging and entertaining to the children as to maintain their attention and motivate them to learn the social skills. At the moment, it seemed that this was to be unattainable and impossible for us to accomplish.
Once they had finished with their skillstreaming session, it was another counselor’s turn to practice. This continued for the next 4 days of training. The first couple of days were strictly for practicing, however after that, the supervisor Erik began taking fidelities on the counselors to judge how accurately we were following the procedure. At the time fidelities seemed like an adversary to me and an unnecessary step in the process, however I can now appreciate their function and validity. As this program was empirically based, it was necessary that a certain level of fidelity was maintained and that the program was to be administered similarly through each team and counselor. Each counselor was required to reach a 90% on their skillstreaming fidelity before they would be allowed to participate in the actual camp. However, we had the opportunities to repeat skillstreaming sessions as many times as it was necessary to reach the desired percentage. Personally, I passed my fidelity on my second attempt, which was common for most of the counselors.
At the end of training week, we were asked to decide upon a team name that we would be referred to hereafter and to create a poster with that name plus a point-board that would be used to keep track of the progress the children had made throughout the week. Danielle and I agreed that we would be called “The Fearless Falcons.” As our week of training came to an end, and we set up the “classrooms” that we would be using (they were in fact rooms and empty apartments located in the Delevan Townhouses at Canisius College).
During the first week of camp, my team had difficulties with executing the program to the standards that the research team desired. They had some concerns with our delivery of skillstreaming and our timing. I explain this by the fact that we had a more difficult situation to deal with at the beginning with having to become adjusted to our team leader as we met her on the first day of the actual camp. The rest of the teams had bonded over the training week and were familiar with each others delivery styles and had been coached by their returning team leaders on appropriate methods and tricks for skillstreaming. In contrast, we were expected to hit the ground running that first week and thus experienced some minor set-backs.
However, after the first week, our team quickly became well adapted and thrived with the structure of the program. Fidelities were taken randomly throughout each week with each of the teams throughout the program as to record and maintain its validity; our team, for the majority of the weeks, was the highest scoring on our fidelities. As a scientist, I appreciated that they continued taking fidelities throughout the program. If I was to be a reading one of their research papers, the continuous and correct application of the program would have been a concern of mine for the validity of the study; however with the information they had regarding their fidelities it would put any of those concerns to rest. The fidelities also provide a rubric for other individuals who wish to replicate the program in their environments, most notably schools. They can be assured then that they are following the program as it was meant to be prescribed.
Throughout the program, I witnessed the changes that the children made in their behaviors. Day by day they were hard to take notice of, but comparing the beginning of the program to the last day it was drastic. One child in particular, I will refer to him as N, experienced the greatest amount of change. He came from a family of six children all under the age of 12; resultantly, his home life was chaotic and unorganized. He started the program with great resistance and would act out. He showed a propensity for unnecessary violence and unwillingness to cooperate with our procedures. In one incident, we were playing a river crossing game in which the children had to use their newly learned social skill to cross an imaginary river using only two wooden planks. N did not wish to help the other children to cross the river and in his fascinations with the wooden planks picked one up and began swinging it around, hitting a counselor in the arm. As a consequence he lost points and was put in time out. It was during these beginning days that we noticed his lack of motivation to follow the program and find enthusiasm behind it coupled with a lack of empathy for other children (a normal symptom of Aspergers).
However, towards the end of camp, we started to notice N using the social skill of the day without being prompted to do so and encouraging other children who were struggling. It was at this point that I began to believe that the program was working for N. The factor that solidified this belief in my mind was when we were told of a thank you letter that N’s mother had written the research staff. She had expressed an immense gratitude to our program for truly changing her son’s behavior for the better. She explained how he came home every day and would teach his brothers and sisters proper social skills, he would take away points accordingly for negative and inappropriate behaviors they would do, and actually started a conversation with his next-door neighbor (something that had never happened in all of N’s life his mother said). Hearing the impact that our work had made on N brought my entire team almost to tears; it was a very moving experience to hear first-hand just how we had changed this boy’s life.
The experience with N made me change my perspective on “problem children.” In an outside setting, N would have been given up as a lost cause and as a trouble maker when in fact his negative behavior was a result of his home life. He himself was a nice boy who wanted to please and to learn, all he had required was some strict direction and positive influences. N could have been considered the hardest to control on our team and had the possibility of deteriorating and becoming even harder to handle. However, due to our strict adherence to the program and our perseverance with him, his behavior consistently decreased. It was said that our team had the least amount of negative behavior, possibly due to the children who had been assigned to our team, or more likely that it was evidence of the success of the program when administered correctly.
Our team functioned as professionally as possible. We did not become “friends” with our children. This allowed them to develop their social skills without using us as crutches. At the end of camp we felt very confident that our children were going to retain a high percentage of the skills that they had learned during camp, even without us present to help guide them.
The most important lesson I will take away from my time at Connections will be the importance of discipline and direction with children. I understand now the proper way to give a time-out and how to communicate your authority to them. It is critical for one to not make empty threats to children as they will lose respect for your commands after the second time you tell them to do something. I see parents struggling to control their children, continuously repeating a command and then threatening to reprimand them in some form, but never following through and never making them perform the requested act. When I have children, I will ask them once to perform some desired act, if they do not comply I will warn them that if they do not follow my orders after I ask them a second time that they will then receive a time out. If they still do not comply after my second request, I will then place them in time-out.
Working at Connections also helped me to identify if I was interested in working with children in my future. At the beginning of the program I was apprehensive, as I had been told of the difficulties one faces when working with such a population of children. However, I ended the program intrigued by childhood psychopathology and a sense of hope that I believe one does not receive when working in adult clinical settings. It was very hopeful to see that these children were still young enough that our work with them would make a major difference in the course of their lives. They have many years ahead of them and I know that my participation in the program helped ease the difficulties they might have faced if they had not done the summer camp. I am also grateful for the practical application experience the program has provided me. It as definitely enhanced my personal knowledge and advanced my cv by making me a more desirable candidate for graduate school programs.
I had previously been briefed by Dr. Putnam about what I could expect from this experience: long hours, stressful days of working with children who had mental deficits, but also of the great reward counselors experienced at the end of the program. Thus I began my training week with mixed feelings. I was nervous yet excited to begin the process. At a previous meeting, all counselors had been provided a copy of the manual of the program that they were to have memorized by the beginning of the program. This included the DSM-IV description of Aspergres and Autism, a detailed outline of their procedure for teaching the social skills (a nine-step process called “Skillstreaming”), and the various behaviors that would be assigned either negative or positive point values. Tension surrounding the first day of training surrounded this manual as all counselors were required to pass a test on the manual with a 100%. If you did not, you would be unable to participate in the program.
That first day, everyone arrived at 8am in the morning and immediately we took the test on our knowledge of the manuel. After two weeks of constant studying and memorization, it is a relief to see what has been asked on the exam. We had been told to memorize verbatim the different behaviors definitions and their point values, the clinical definition of Aspergers, along with the order of the skillstreaming steps and their operational definitions. Within the program, behaviors were altered through rewards in the form of points. These points were called out by counselors as they happened and tallied on a score sheet. At the end of each day these pointed were counted and recorded in a master file that calculated their totals for each day and a weekly total. These weekly totals were used to determine whether or not the children had earned the right to go on the week’s end fieldtrip.
After taking the exam, we were assigned to our three person “teams.” My team consisted of Danielle Schmidt who I had previously known through Canisius, and Ashley Warhol, who had participated in the program for 3 years prior but who could not attend training week due to class scheduling conflicts. This placed an added stress on Danielle and me as we were unable to bond and get to know our team leader before we started the program. After the test was finished and an introduction had been made by Dr. Thomeer and Dr. Lapata, the counselors began to practice “skillstreaming.”
This was to be the bulk of what we did through training week. Three people would work together as a “team”, with only one actually leading the skillstreaming, and then six other counselors would volunteer to act as the children; the remaining counselors would watch the role-play. The first few counselors who led a mock skillstreaming session were veterans who had previously been through the program. It was very intimidating for the first year counselors as the cadence in which they went through the steps and their level of engagement with the “children” was very fast and intense. Each skillstreaming session is to be exactly 20 minutes in length, a feat which at times is difficult to achieve. Along with the time limitations it is critical for counselors to be engaging and entertaining to the children as to maintain their attention and motivate them to learn the social skills. At the moment, it seemed that this was to be unattainable and impossible for us to accomplish.
Once they had finished with their skillstreaming session, it was another counselor’s turn to practice. This continued for the next 4 days of training. The first couple of days were strictly for practicing, however after that, the supervisor Erik began taking fidelities on the counselors to judge how accurately we were following the procedure. At the time fidelities seemed like an adversary to me and an unnecessary step in the process, however I can now appreciate their function and validity. As this program was empirically based, it was necessary that a certain level of fidelity was maintained and that the program was to be administered similarly through each team and counselor. Each counselor was required to reach a 90% on their skillstreaming fidelity before they would be allowed to participate in the actual camp. However, we had the opportunities to repeat skillstreaming sessions as many times as it was necessary to reach the desired percentage. Personally, I passed my fidelity on my second attempt, which was common for most of the counselors.
At the end of training week, we were asked to decide upon a team name that we would be referred to hereafter and to create a poster with that name plus a point-board that would be used to keep track of the progress the children had made throughout the week. Danielle and I agreed that we would be called “The Fearless Falcons.” As our week of training came to an end, and we set up the “classrooms” that we would be using (they were in fact rooms and empty apartments located in the Delevan Townhouses at Canisius College).
During the first week of camp, my team had difficulties with executing the program to the standards that the research team desired. They had some concerns with our delivery of skillstreaming and our timing. I explain this by the fact that we had a more difficult situation to deal with at the beginning with having to become adjusted to our team leader as we met her on the first day of the actual camp. The rest of the teams had bonded over the training week and were familiar with each others delivery styles and had been coached by their returning team leaders on appropriate methods and tricks for skillstreaming. In contrast, we were expected to hit the ground running that first week and thus experienced some minor set-backs.
However, after the first week, our team quickly became well adapted and thrived with the structure of the program. Fidelities were taken randomly throughout each week with each of the teams throughout the program as to record and maintain its validity; our team, for the majority of the weeks, was the highest scoring on our fidelities. As a scientist, I appreciated that they continued taking fidelities throughout the program. If I was to be a reading one of their research papers, the continuous and correct application of the program would have been a concern of mine for the validity of the study; however with the information they had regarding their fidelities it would put any of those concerns to rest. The fidelities also provide a rubric for other individuals who wish to replicate the program in their environments, most notably schools. They can be assured then that they are following the program as it was meant to be prescribed.
Throughout the program, I witnessed the changes that the children made in their behaviors. Day by day they were hard to take notice of, but comparing the beginning of the program to the last day it was drastic. One child in particular, I will refer to him as N, experienced the greatest amount of change. He came from a family of six children all under the age of 12; resultantly, his home life was chaotic and unorganized. He started the program with great resistance and would act out. He showed a propensity for unnecessary violence and unwillingness to cooperate with our procedures. In one incident, we were playing a river crossing game in which the children had to use their newly learned social skill to cross an imaginary river using only two wooden planks. N did not wish to help the other children to cross the river and in his fascinations with the wooden planks picked one up and began swinging it around, hitting a counselor in the arm. As a consequence he lost points and was put in time out. It was during these beginning days that we noticed his lack of motivation to follow the program and find enthusiasm behind it coupled with a lack of empathy for other children (a normal symptom of Aspergers).
However, towards the end of camp, we started to notice N using the social skill of the day without being prompted to do so and encouraging other children who were struggling. It was at this point that I began to believe that the program was working for N. The factor that solidified this belief in my mind was when we were told of a thank you letter that N’s mother had written the research staff. She had expressed an immense gratitude to our program for truly changing her son’s behavior for the better. She explained how he came home every day and would teach his brothers and sisters proper social skills, he would take away points accordingly for negative and inappropriate behaviors they would do, and actually started a conversation with his next-door neighbor (something that had never happened in all of N’s life his mother said). Hearing the impact that our work had made on N brought my entire team almost to tears; it was a very moving experience to hear first-hand just how we had changed this boy’s life.
The experience with N made me change my perspective on “problem children.” In an outside setting, N would have been given up as a lost cause and as a trouble maker when in fact his negative behavior was a result of his home life. He himself was a nice boy who wanted to please and to learn, all he had required was some strict direction and positive influences. N could have been considered the hardest to control on our team and had the possibility of deteriorating and becoming even harder to handle. However, due to our strict adherence to the program and our perseverance with him, his behavior consistently decreased. It was said that our team had the least amount of negative behavior, possibly due to the children who had been assigned to our team, or more likely that it was evidence of the success of the program when administered correctly.
Our team functioned as professionally as possible. We did not become “friends” with our children. This allowed them to develop their social skills without using us as crutches. At the end of camp we felt very confident that our children were going to retain a high percentage of the skills that they had learned during camp, even without us present to help guide them.
The most important lesson I will take away from my time at Connections will be the importance of discipline and direction with children. I understand now the proper way to give a time-out and how to communicate your authority to them. It is critical for one to not make empty threats to children as they will lose respect for your commands after the second time you tell them to do something. I see parents struggling to control their children, continuously repeating a command and then threatening to reprimand them in some form, but never following through and never making them perform the requested act. When I have children, I will ask them once to perform some desired act, if they do not comply I will warn them that if they do not follow my orders after I ask them a second time that they will then receive a time out. If they still do not comply after my second request, I will then place them in time-out.
Working at Connections also helped me to identify if I was interested in working with children in my future. At the beginning of the program I was apprehensive, as I had been told of the difficulties one faces when working with such a population of children. However, I ended the program intrigued by childhood psychopathology and a sense of hope that I believe one does not receive when working in adult clinical settings. It was very hopeful to see that these children were still young enough that our work with them would make a major difference in the course of their lives. They have many years ahead of them and I know that my participation in the program helped ease the difficulties they might have faced if they had not done the summer camp. I am also grateful for the practical application experience the program has provided me. It as definitely enhanced my personal knowledge and advanced my cv by making me a more desirable candidate for graduate school programs.
