The first week of this internship involved 40 hours of training. Prior to this week we were expected to memorize the manual created for this summer program. Connections is a summer program for children with High Functioning Autism, and a strict manualized treatment is exactly the structure they need. When we arrived on Monday all of the counselors were required to pass an exam about the manual with a 100%. We were not allowed to administer the program without this score. The first day consisted of lectures regarding the program and what to expect with children with High Functioning Autism. The remainder of the week involved learning and practicing "Skill Streaming" , "Therapeutic Activities" and the point system that we would be using during the camp. The purpose of this summer camp is to teach children with High Functioning Autism how to use social skills. The camp's belief is that the children have social skills and are just unsure as to how to use them.
"Skill Streaming" is a concept coined by Dr. Goldstein, in which a social skill is introduced and explained, modeled by the an adult, in our case a counselor, and then acted out for the children. The children are then asked to think of a time when they used this social skill and then those selected will perform this for the rest of the group. "Therapeutic Activities" are activities they supplement the social skill we just learned. Some involve team work (crab soccer, 'don't break the egg'), while others are fun recreational activities to highlight all social skills learned (pool, board games). The point system was the Little did I know how much easier it would be to practice these routines with my peers than it would be to run the program with children. The point system is put in place to act as both a positive reinforcer and a punishment. Children earned points for using their social skills and lost points not following the specific rules of the program. There were six program rules that were reviewed before every "Skill Streaming" and "Therapeutic Activity". These rules included 1) Be actively involved 2) Stay in seat/area 3) Use the materials correctly 4) Follow rules of the specific activity 5) Speak so others can hear you clearly and 6) Raise your hand to speak. There were also "Friendship Skills" which children could lose points. A few examples for which children could lose points under "Friendship Skills" were 1)Violating Personal Space 2) Violating Personal Space with Harm 3)Interruption 4) Poor Eye Contact 5)Sharing irrelevant information 6)Run-on Communication. If a child did not lose points for violating Program Rules or Friendship Skills, they earned 50 extra points per section for a total of 100 extra points. Because the Connections Program is a research based program, we were also required to pass fidelity tests with a 90% or better at any given time during the program.

After 40 hours of training, the first week had finally arrived. I was very fortunate to have been placed with a veteran counselor who had run the program before. There were three counselors (2 females and 1 male) for a group of 7 children (5 boys and 2 girls) who were all 8 years old. One boy and one girl in the group were twins. I found this to be very interesting because as I learned in my Autism and Developmental Disabilities class, ASD (Autism Spectrum Disorders) is not necessarily genetic in that it is passed down from generation to generation, but the chances of siblings having this disorder increases. It is more probable that identical twins will both have ASD, but in this case it was fraternal twins who both had ASD. We were also made aware that they had an older sister who didn't have any symptoms of ASD.
One of the deficits children with autism have is opposition to change in routine. Many of the campers were nervous about this new event, so from the second we opened their car doors, our energy and enthusiasm had to be over the top. We started the program the second they walked into the door. It was decided that the veteran counselor would start the day off so we could began on a good note. Each day consisted of 6 cycles, 5 (70) minute treatment cycles and a lunch. The campers arrived at 8:30 and the program started promptly at 8:40. From 8:40-9:00, during the first "Skills Streaming", our veteran counselor explained the program to the campers and introduced them to the point system. Before they even knew what was coming we started to call out points.
The very first "Therapeutic Activity" we did, was entitled "Proudly Presenting". The campers were paired into groups of 2 or 3 and were asked to complete questionnaires on their new friends. This was a great way for us to see some of the social deficits these children had. Many didn't make eye contact which is common among individuals with ASD. Some of the campers had attended the program last year, and three of the campers went to the same school. As many would say by the end of the camp, our group was one of the closest because the kids got along so well. The social skills we learned that day were 'Contributing to a Discussion' and 'Listening'. One would think, 'Contributing to a Discussion', these kids speak, so why do they need help with this? Another deficit that people with ASD have, is persistent preoccupation with parts of an object. Our children were able to have conversations, but not socially appropriate conversations. A lot of our campers LOVED Pokemon. This was the subject of most conversations. By teaching them the social skill of 'Contributing to a Discussion', they learned how important it is to talk about a variety of subjects. Little did I know how important our last social skill of the day would be. We practiced the social skill of 'Listening' twice. The last activity of the day was kickball, and some of the kids didn't know how to play. Individuals with ASD typically have poor motor skills, this is not helpful when playing a sport. One of our kids had a meltdown because he couldn't understand the rules of the game, when I tried to explain this to him he wouldn't 'Listen'. Trying to get him to calm down was a struggle, resulting in a 25 minute time out.
The summer program is most closely related to my Behavior Modification class. The objective of the camp was to increase positive, socially appropriate behaviors, and decrease negative, socially awkward behaviors. This could be accomplished by reinforcement and punishment (time-out). The social skill of 'Being a Good Sport', which we learned later in the week helped this camper when we played kickball again. The first week was struggle because I wasn't sure what to expect. I learned very quickly that if we didn't keep our energy up throughout the whole day, we would lose the kids. After the first week, we had a long weekend, which allowed me to rest and become more focused and prepared for the weeks to come.

To start this week, we were going to implement IDN's (Individual Daily Notes). We were instructed to watch our kids during the first week and note any inappropriate or distracting behaviors. The IDN's would help us to shape their behaviors. As mentioned in my Behavior Modification class, a behavior must be defined in terms of measurement (operational definition). When deciding what behaviors to focus on for each child, it was important that we focused on on changing behavior, and not characteristic traits of the individual. For example one behavioral excess that we wanted to decrease for one of the campers was talking like a baby. Whenever this camper had a conversation, she spoke in a baby voice. A behavioral deficit we worked to increase with many of the campers was having a conversation. After practicing the social skills of 'Contributing to a Discussion', 'Having a Conversation', 'Introducing Yourself', and 'Ending a Conversation', we felt the campers would have no problem meeting this goal. The behavioral issues were different for each child, but the reward was the same. If the child passed their daily IDN they earned a reward (a Popsicle) at the end of the day. If the camper passed their IDN at least 4 out of 5 days, they were allowed to attend the field trip. However, if the camper was losing hundreds and hundreds of points every day, they were also in jeopardy of missing the field trip. We hoped that this contradiction didn't happen because that meant we were focusing on the wrong behaviors on the IDN. So now not only were they required to earn a specific number of points, but they were required to pass their IDNs. During this week of IDN implementation, it was important to identify the underlying causes of the behaviors. At this point there were not many uncontrollable behaviors we needed to be concerned about. We were told our kids were still in the 'honeymoon' phase.
We were expected to make adjustments in the children's IDNs on a weekly basis. After learning the social skill of 'Giving Instructions', one camper needed some extra assistance with the appropriate way to use this skill. She was often frustrated with a fellow camper who was more lower functioning than anyone else in the group. When giving this camper instructions, she used a harsh and condescending tone. Because this occurred frequently during this week, we decided decreasing this behavior needed to be added to her IDN.
After a week of adjusting to the implementation of the IDNs, all of our kids earned the weekly field trip. This week's field trip was to the Naval Park. Our kids did a great job with transitioning from our classroom to the metro station. They were so excited about riding on the subway, that they didn't even remember to act out. However, the time on the naval ships was a completely different story. Two of the boys who had become very close had difficulty using their social skill of 'Listening'. We had to issue a few time-outs, but this punishment did not prevent further negative behaviors. I was concerned this was foreshadowing more disastrous field trips.

One of the main themes of this week was emotions. Some of the social skills we learned this week were, 'Knowing your Feelings', 'Expressing your Feelings', 'Using Self Control', 'Recognizing Another's Feelings', and 'Understanding of Another's Feelings'. As defined by the DSM-IV-TR, Diagnostic Criteria for ASD is impairment in social interaction, specifically lack of social emotional reciprocity. Individuals with ASD lack the ability to share interests and enjoyments with others. When an individual can't express him/herself, it is very difficult to establish and maintain meaningful relationships. All humans should experience the benefits of having close friendships, and by teaching the campers these skills, I think we helped to provide much needed assistance. After taking my Autism and Developmental Disabilities class I have seen the benefit of training devices such as video modeling. When an individual with ASD watches others act out a particular skill or behavior, they can often learn to model these actions and behaviors. By explaining the social skills and demonstrating a personal experience, I think our kids understood the skills much better. As college students without ASD we were able to genuinely perform skits demonstrating the use of these emotional social skills. The more we modeled these difficult skills, the easier it was for our children to obtain these skills.
Our field trip for this week, was to the Buffalo Zoo. Our kids did a MUCH better job of following rules and listening. However, we were there for a couple of hours and the kids started to get annoyed and exhausted from the heat. As previously mentioned, the second you start to lose the attention of an individual with ASD, it is very difficult to get them back on track.

This week was also filled with more emotionally based social skills. Some included, 'Accepting Consequences', 'Apologizing', 'Dealing with being Left Out', 'Responding to Teasing', 'Dealing with your Anger', and 'Avoiding Trouble with Others'. This week was the most challenging of the entire camp. Two of our campers had their worst week's yet, and failed their IDNs on two days. One was almost in jeopardy of not earning any points one day because of the number of points he lost. I noticed this week more than ever, one of the boys was constantly losing points for 'Not being actively involved'. He was too concerned with what the boy sitting two people down from him. Whenever one would act out, the second would shortly follow. This was one underlying cause of behavior that we picked up on during the camp. Unfortunately for those two campers, both were refused a spot on the end of the week field trip. As soon as one boy in the group realized his friend was not joining us, he couldn't stop crying. I sat next to him on the bus and managed to calm him down. We went to Bounce Magic which like the Zoo was entertaining for a short while, but became tedious. After we returned from the field trip we went over some of the social skills we had learned during the week. We spoke with the two boys who hadn't made the field trip prior to this review to make sure they were aware why we picked these skills.

The 6th and final week was all about reviewing social skills. We performed a lot of the same 'Therapeutic Activities', but randomly selected skills we thought the kids still needed to review. We spent two treatment cycles working on our final field trip t-shirts. I was very impressed with how engaging the kids were with this activity. I could see how they had improved over five short weeks. They were using compliments, having conversations, contributing to a discussion etc. During the middle of the week we had another group join us in a game of 'two truths and a lie'. This was a group we didn't normally spend time with because they were at least two years older than our kids. This was also a moment that made me extremely proud because they all did such a good job of listening to one another, asking important questions and giving compliments on their peers examples. On Friday the 30th we took the kids to Fantasy Island for the final field trip. We taught them one final social skill we hadn't learned during camp prior to leaving for the trip. It was 'Saying Goodbye'. The kids did an amazing job with picking appropriate examples and realizing the connection between those examples and the fact that we would all be saying goodbye later that day. They really enjoyed the field trip and behaved better than we could have asked. We missed out on one ride and one camper became really upset. He couldn't understand why we couldn't have the bus wait for us to ride this ride. I felt bad, but I felt it was a good learning experience. Throwing a tantrum will not get us what we want. By leaving without going on this ride, the camper had to 'Accept Consequences' and 'Be a Good Sport', skills we had learned this summer. The most rewarding moment of this summer was when the end of the program reward ceremony. We invited our camper's parents to join us at the end of the day to be apart of our ceremony. The smiles that not only the kids had, but that their parents had showed us how appreciative they were of our program. The kids worked very hard and deserved their own individual awards. They were so excited to hear about their improvements, and they deserved the recognition. All of our kids had a wonderful summer and I feel so fortunate to have been a part of this program. As we said goodbye to our group, I said goodbye to a camper saying 'Bye, see you later'. This was not the version of saying goodbye that the camper had learned earlier that day during 'Skills Streaming', so he said 'Miss Kristie, you mean goodbye, good luck, and take care.' That was exactly what I meant..