Summit Educational Resources, Canisius College
Connections Summer Program
Week 1 (June 20-24)
This week was dedicated to training the research clinicians. Training took place in the Health Science Building at Canisius College. We had to complete 40 hours of training this week in order to be prepared for the start of the program. The first thing we had to do on Monday morning was take an exam on the program manual. When we were hired for the internship, we were given the program manual. Dr. Thomeer and Dr. Lopata from Canisius College wrote the manual. Being a licensed manual and program, we had to show a thorough understanding of the procedures we would be using. As the research clinician, I am implementing an intensive research program and will be collecting data that will be used in a published article, so it is important to be very knowledgeable on the material. The exam consisted of multiple choice and verbatim questions. If we got any of the questions wrong, we had to take the test again until we earned a 100% (mastery).
This year the program is led by Summit Educational Resources instead of the Institute of Autism Research and is called “Community Connections” because the camp had to be led by other researchers to prove they can get the same results. The directors of the program (Dr. Meichenbaum and Dr. Toomey) and the supervisors (Rachel and Christin) taught about general information about autism and Asperger’s disorder, as well as instructions on how to carry out skills streaming and therapeutic activities with the children. We also had to learn the point system because it is so important in the program. The children earn points for using positive social skills and following the rules, and lose points for using negative behaviors. The behaviors children earn points for are using social skills A, B, and C of the day, using prior social skills (skills they have learned on other days), and bonus points for not losing any points in that interval. The behaviors children lose points for are not being actively involved in the activity, using materials incorrectly, being out of seat/area, violating specific rules of the activity, violating personal space, violating personal space to cause harm, using poor eye contact, interrupting, sharing irrelevant information, and run-on communication. Much of our learning consisted of taking turn practicing the different roles. We set up our rooms in the Delevan Townhouses with our teams. Three counselors and seven children are on each team. My team consists of Miss Amy, Miss Jen, and myself. We have seven seven-year-old boys. Our team name is the “Courageous Cruisers.”
Week 2 (June 27-July 1)
Monday was the first day with the children. They arrived at 8:30 on the dot. The counselors went outside to the line of cars and got the kids out of their cars. I was nervous because I was unsure how the day would go, and I did not feel completely comfortable with all of the skills I’m required to have. I have to know how to respond to the children in many different roles: research clinician, camp counselor, model, helper. The first day consisted of teaching the kids how this “camp” works and that they will be learning a lot of social skills and doing really fun activities to practice these social skills. We also introduced them to the program rules that we go over before all activities. The program rules are be actively involved, stay in seat/area, use materials correctly, follow specific rules, raise your hand to speak, and speak so others can hear you. We have to be very enthusiastic and excited about the social skills and activities to show the children they would be having fun. We also had to show the children how exciting it was to earn points for using social skills and to earn the rewards (popsicles, home rewards, field trip).
We taught social skills through “skills streaming.” This is the first twenty minutes of each cycle and there are five cycles each day. In skills streaming, we teach them the steps of using the social skill, then role play the skill, then ask the children to give examples and role play the times they used the skill. The social skills we taught in the first week of camp are as follows:
1. Contributing to discussions
2. Listening
3. Giving a compliment
4. Having a conversation
5. Introducing yourself
6. Idioms
7. Facial expressions
8. Being a good sport
9. Offering to help an adult
10. Saying thank you
11. Asking a question
Some of the activities the children did were board games, balloon volleyball, making collages, crab soccer, and kickball. The field trip that the children earned this week was a pizza party and movie. The children did not know that they were all going to earn the reward of going on the field trip no matter what. All of the kids go on the first field trip to have a “taste” of the reward and see that it is something they want to work for the rest of the weeks.
Another component of the program we needed to become comfortable with this week was fidelities. Research assistants come around and watch the clinicians to ensure everyone is following the schedule and manual. The research assistants answer “yes” or “no” for each requirement and we need to receive a 90% or higher each time.
Week 3 (July 5-8)
This was the second week with the children. This was a good week because the children are now becoming more comfortable with each other, the counselors, and the schedule of the camp. They are there from 8:30-4:00 and are active the entire day, so it is understandable they get tired toward the end of the day. It is interesting to observe the differences in their attitudes and behaviors depending on what time of day it is and what type of activity we are doing. Some of the children are also diagnosed with ADHD and show inattentive behaviors in the afternoon. We started using IDN’s (Individual Daily Notes) with the children this week. An individual daily note is a behavioral plan that is individualized for each child to target specific behaviors. The higher the percentage the child earns on the IDN, the better the reward. The IDN is also a way to connect the child’s progress at camp with home. If their parents uphold the rewards at home, the child is able to see the connection between using good behavior outside of the home and how they can earn something they want with their parents. This is a key factor in the generalization of their social skills and behaviors. The IDN is also used as a measure of child’s behavior. If the child fails their IDN two days in one week, they are not allowed to go on the field trip.
The social skills we taught this week are as follows:
1. Following instructions
2. Giving instructions
3. Joining in
4. Facial expressions
5. Non-literal language
6. Sharing
7. Asking for help
8. Accepting a compliment
9. Ending a conversation
Many of the therapeutic activities are the same from week to week, but this week we also did activities such as swimming in the pool, computer activities, obstacle courses, hula hoop relay, freeze tag, and four square.
All of my kids earned the field trip this week; however one of the mothers did not bring her son to camp on Friday. This was frustrating because the child did not get to experience the reward of the field trip with the other campers and see that it is something he wants to keep working for. The field trip was a trip to the Naval Park. The kids were very excited to ride the subway and see the naval ships.
Week 4 (July 11-15)
This was the third week with the children. The social skills we taught this week are as follows:
1. Offering to help a classmate
2. Knowing your feelings
3. Expressing your feelings
4. Ignoring distractions
5. Using self control
6. Non-literal language
7. Facial expressions
8. Recognizing another's feelings
9. Understanding of another’s feelings
10. Asking permission
11. Having a conversation (repeat)
We had to alter some of the children’s IDN’s this week. We can alter the IDN’s by changing target behaviors to work on or decreasing the amount of reminders we have to give for negative behaviors. This forces the children to work harder to earn their reward. We had a very difficult time with one of our children this week. He began showing aggressive, impulsive, and non-compliant behaviors that were drastically worse than at the beginning of camp. He desperately wants to be a part of all of the activities and work well with the other children, yet he has a difficult time controlling his behavior when he becomes emotional. A target behavior on his IDN is to deal with his anger in an appropriate way. This child did not earn the reward of the field trip this week, which was the Buffalo Zoo. He was very upset and disappointed and understood why he was not able to go, so I am interested to see how he behaves next week after seeing the consequences of his behavior.
In the middle of this week I became the lead counselor for the group. Our lead counselor had to pull out of the program for health reasons, so Rachel and Dr. Toomey asked me to take on the position of lead. It made me feel good to know they thought I was capable of taking on more responsibility, and I feel confident in my ability to do so.
Week 5 (July 18-22)
The social skills we taught this week are as follows:
1. Accepting consequences
2. Apologizing
3. Dealing with another’s anger
4. Negotiating
5. Expressing concern for another
6. Non-literal language
7. Facial expressions
8. Dealing with being left out
9. Responding to teasing
10. Dealing with your anger
11. Avoiding trouble with others
We did more activities this week such as transformations, group island, charades, don’t break the egg, and three legged race. This was a difficult week for all of the children. By this time in the program, we are hoping to see the kids use social skills with less prompting and therefore show more independence. We are using reinforcement on a continual schedule until the very end of the program, so the children are rewarded every single time they use a social skill they have previously learned. Some of the children are showing they are tired and restless with camp, so some negative behaviors (not being active in the activity, interruption, out of area) were more prevalent this week. The difficulties this week shows how important it is that behavioral treatment and teaching these children social skills continues after camp, such as in a school setting. The child that did not earn the field trip last week had another difficult week but he earned the field trip. We did have another child, however, who did not earn the field trip. He did not earn enough points to go on the field trip, so I had to stay back with him while everyone else went to Bounce Magic. He was upset about this but he saw that he has to work on his behavior for next week.
Week 6 (July 25-29)
This was the last week of camp and the internship. The social skills we used in skills streaming were all social skills we have taught in prior weeks. They also learned the social skill “saying goodbye to others.” Teaching this social skill was very sad because I knew I may not see these children again and I’ve become so attached to them. We made camp T-shirts to wear on the last day and the kids were able to sign the back of each others' shirts. I was really happy to see what they were writing on each others' shirts. They wrote nice notes to each other and showed they developed some great friendships at camp. My favorite time with the kids is often when they are drawing and showing interest in something they like. This was a great time for the kids to use social skills they have been practicing over the last four weeks. They displayed social skills such as having conversations, contributing, listening, sharing, asking for help, giving compliments, accepting compliments, and saying thank you. It was really exciting to see the difference in how they interacted with each other at the end of camp compared to the beginning of camp. The field trip they earned this week was a trip to Fantasy Island. All of the Courageous Cruisers earned the field trip. When we got back to camp after the field trip, all of the kids’ parents were there for a small celebration. We did a small skills streaming session to show their parents what we were doing at camp for five weeks, then gave the kids certificates and awards. Seeing their excitement and emotion was one of the most rewarding things I have ever experienced.
Connection to Course Content:
There were many components of my internship that connected with material I have learned in the classroom. First, I was able to observe the diagnostic criteria for Asperger’s Disorder and High Functioning Autism Spectrum Disorder’s in the children at the camp. As learned in Child Psychopathology, the DSM-IV diagnostic criteria includes:
A. Qualitative impairment in social interaction, as manifested by at least two of the following:
1) marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction
2) failure to develop peer relationships appropriate to developmental level
3) a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by a lack of showing, bringing, or pointing out objects of interest to other people)
4) lack of social or emotional reciprocity
B. Restricted repetitive and stereotyped patterns of behavior, interests, and activities, as manifested by at least one of the following:
1) encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
2) apparently inflexible adherence to specific, nonfunctional routines or rituals
3) stereotyped and repetitive motor mannerisms (e.g. hand or finger flapping or twisting, or complex whole-body movements)
4) persistent preoccupation with parts of objects
C. The disturbance causes clinically significant impairment in social, occupational, or other important areas of functioning.
D. There is no clinically significant general delay in language (e.g. single words used by age 2 years, communicative phrases used by age 3 years).
E. There is no clinically significant delay in cognitive development or in the development of age-appropriate self-help skills, adaptive behavior (other than in social interaction), and curiosity about the environment in childhood.
These characteristics varied greatly in each child, but were all apparent and observable to a certain degree.
I completed the internship before taking the Behavior Modification course with Dr. Sanders. However, it was extremely useful to go through the course after the internship because I was able to connect the content with everything I had learned over the summer. One of the most important connections was my understanding of positive reinforcement. In the program, the children are rewarded with points every single time they use a social skill. I learned in the course that this is using a continual schedule of reinforcement of positive reinforcement for a desired behavior (social skills). The children also lost points for using negative behaviors, which is a form of punishment known as response-cost. I learned in the course that response-cost is a system in which someone can earn something (points) for desired behaviors and lose the same thing or something else for doing negative behaviors. The children also earned popsicles, field trips, and rewards at home as rewards/positive reinforcers.
Another aspect of camp that connected with the content I learned in Behavior Modification is the use of time-outs. It is a form of punishment, and while it has a bad reputation, time-out can be crucial to a change in behavior. Time-outs were used in the camp when a child violated another’s personal space to cause harm and when instructions were not followed after the second time they were given. I learned in the internship and in the course that it is important to have a neutral but firm tone of voice and not to show anger when using punishment with a child.
Much of the content I learned in Behavior Modification this semester had been key components in the Connections program. Both the internship and the course taught me I want to have a career in this field.
Another aspect of camp that connected with the content I learned in Behavior Modification is the use of time-outs. It is a form of punishment, and while it has a bad reputation, time-out can be crucial to a change in behavior. Time-outs were used in the camp when a child violated another’s personal space to cause harm and when instructions were not followed after the second time they were given. I learned in the internship and in the course that it is important to have a neutral but firm tone of voice and not to show anger when using punishment with a child.
Much of the content I learned in Behavior Modification this semester had been key components in the Connections program. Both the internship and the course taught me I want to have a career in this field.
