OTS 21: Autism Strategies Featuring Meg Proctor
- Jayson Davies
- Jan 6, 2019
- 35 min read
Updated: Apr 14
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Welcome to the show notes for Episode 21 of the OT Schoolhouse Podcast.
In episode 21 of the OT Schoolhouse Podcast, guest Meg Proctor of LearnPlayThrive.com joins Jayson to share five essential strategies for occupational therapists who work with students who have Autism.
Meg is an experienced pediatric occupational therapist who specializes in the provision of services with children diagnosed with Autism Spectrum Disorder. She currently sees clients privately and provides both live and self-paced online trainings through Learn Play Thrive, LLC.
To learn more about Meg and Learn Play Thrive, visit LearnPlayThrive.com and click on "For Therapist" at the top to grab a free ebook on how to help kids with Autism who do not have many occupations.
If you enjoyed this podcast and would like to dive in further with Meg on her full 6 Module course, Click here and use promo code schoolhouse25 for a special discount for OT School House Podcast Listeners only!
Be sure to also visit Meg's Facebook group, "OT & Autism" for occasional live videos and extra content for Meg.
Also mentioned in this podcast is a survey we are currently conducting. We would appreciate your help in directing our next step in helping you succeed. As a thank you, you will receive a discount code for a Podcast Professional Development Opportunity.
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Be sure to subscribe to the OT Schoolhouse email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs.
Have any questions or comments about the podcast? Email Jayson at Jayson@otschoolhouse.com
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Episode Transcript
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Amazing Narrator
Hello and welcome to the OT schoolhouse podcast. Your source for the latest school based occupational therapy tips, interviews and research now to get the conversation started, here are your hosts, Jayson and Abby. Class is officially in session.
Jayson Davies
Hello and Happy New Year. Welcome to 2019 and episode 21 of the OT school house podcast. Hope you all are enjoying your winter break and well, by now, I'm back, and I bet some of you are back. Some of you may be going back next Monday, but all in all, welcome back to the podcast. Welcome to 2019 and welcome back to work in your school or pediatric setting, or wherever else you may be. I know we have actually some some educators that listen to this. So welcome back. So last year, before we had the podcast, we kicked off the year with a blog post that kind of outlined what Abby and I wanted to do here at the OT school house, and part of that was actually beginning the podcast, and, well, now we have the podcast. So instead of doing a blog post this time, we're going to just kind of do it on the podcast, concerning most of you listening now on the podcast, versus, uh, seeing the blog post that we have. So we're going to kind of focus on the podcast more this year. I know right now we're doing an episode once every two weeks, and I think our goal is to get it to be weekly for you all, and so we can bring on more guests. Have on more discussions between Abby and I about what's going on in our school based life and and what may be going on in your school based life. And so we want to talk about IEPs, talk about services, talk about even deeper into goals, maybe have some of our favorite guests back to talk about vision and talk about autism and and that's actually where we're headed today, is is autism. But first I want to talk about two more things that are on our radar for the for the rest of 2019 and one is that we want to become a OTA approved as a provider of continuing education through this podcast. Right now, you can earn continuing education through the podcast, and it is completely viable for you to use for your NBC ot renewal. However, we're not a OTA approved yet. Not that it's a huge deal, but we would like to be officially recognized by a OTA as a professional development provider. And with that, I also want to acknowledge the glass half full podcast. They actually recently just got acknowledgement from a OTA as a CEU provider for several of their episodes. So they're doing similar concept that we are, where you listen to the professional development podcast and then you can take that short quiz afterwards. And so it's really cool to know that a OTA is backing them up and saying, Hey, yes, this is a viable way to earn professional development. And so that's kind of really lifting for Abby and I, because it's like, whoa. You know, we had this idea, and we didn't know someone else was working on it with a ot eight. So now we know that, and you guys can be be also confident. You know what, that this is something that will be able to be used as professional development for your state. And hopefully, well, it's already available for NBC, OT, but hopefully even more so for your state licensure, it's going forward. So we're excited about that, I guess we could say so hopefully that will come in 2019 and then the last thing that we are hoping to get out sooner than later is a larger course for you all. Actually, this will be a course that you would take online through our website, the otschoolhouse.com and I don't want to release quite yet what it will be about, but some of you have taken a survey for us, and we thank you so much. If you're still wanting to take that survey, I'll put the link in the show notes at ot schoolhouse.com, forward slash episode 21 we'll appreciate that if you do. But we're kind of headed in that direction. We're working on it. We got an outline, and we're putting it together for you all. So hopefully that'll come sooner than later. But with that, you know what? Let's jump into our very special guest today, as I hinted earlier, it is about autism and our guests. Her name is Meg Proctor, and she is an occupational therapist. She's actually currently on the East Coast, and we'll get into that a little bit, but super happy to have her on. She is a autism specialist in her own right, and she taught me a lot of valuable information through not only the podcast that you're about to hear, but also she allowed me to jump in on her course that she has, and that course is actually open right now and again, we'll talk about that a little bit more if you want to dive in deeper with Meg. But she's fantastic. Her course is amazing. She gives a lot of information about autism, and today we're going to talk about the five essential strategies that any ot should know when working with a student with autism. All right, I know this has been a really long intro, but I wanted to share all those really cool things we got going on with you. So without further hesitation, let's jump into our interview with Meg. Doctor of learn playthrive.com. Hey, Meg, welcome to the OT school health podcast. How are you doing today?
Meg Proctor
I'm great. Thanks. Jayson, I'm happy to be here.
Jayson Davies
Thank you so much. We appreciate you being here and looking forward to talking a little bit about kids with autism and some ways to help them out. So before we get into that, though, would you like to give a quick background information about who you are and what you're up to these days.
Meg Proctor
Yeah, absolutely. So I've had a little bit of a winding journey in my ot career to get to where I am now. So when I started as an OT right out of OT school, I jumped right into early intervention, and I was really excited, and then quickly I was like, What on earth am I doing? I wanted to do all these best practices like parent coaching and come to families, homes without a bag of toys, things that I had never seen anybody do and didn't know how to do. And I felt all this pressure like, Oh, these families really need me, and I don't know what I'm doing. And I was working mostly with young kids with autism, so I made a little bit of a shift into school based practice where I felt a lot more supported, and I had a team, and I could really get my feet under me as a new therapist, but I still felt in my very autism heavy caseload, that I was missing some really sort of important intervention knowledge about how to best support my kids with autism. So eventually I moved back to Asheville, where home is from Chapel Hill, where grad school had been, and I got this amazing job at UNC Chapel Hill's teach autism program as a clinical faculty member there, and I got trained and trained and trained and mentored and trained some more in autism. And that whole time, I was thinking, oh my gosh, I just wish I'd known all of this all those years, working in early intervention and working in the schools. And I got trained to be a trainer for their program, and I was training teachers and speech therapists and psychologists from all over the world. I was like, Where are the OTs? We need this so badly. So I eventually launched into my own private practice. I don't work for teach anymore, and I have a business called learn, play, thrive, where I work with families of kids with autism, and one of my favorite parts of what I do is I train therapists in how to work more effectively with their clients with autism.
Jayson Davies
Great. That sounds really cool and really fulfilling at the very beginning, you kind of mentioned about going into into the kids house without a bag of toys. Is that like a common thing, or is that something that you're kind of just doing? Or I've never heard of an OT walking around without a bag of toys behind them?
Meg Proctor
Yeah, in early intervention, that's considered best practice now, to use the materials that are actually available in the natural environment so that families can learn the strategies and keep using them after you leave. But what OTs have done for forever is come in with the Mary Poppins bag, do lots of fun stuff, and then leave, and it's kind of like, yeah, who cares? That was one hour of the week. And it doesn't matter when we're making it impossible for families to have carryover, because we're bringing these special things.
Jayson Davies
That's very true. We kind of come in with our special toys, and then we're like, all right, your kid made progress. Now, time to take the special toys away. That's true. So I like your idea of using the toys that that they already have. And I think that goes for school based therapists. You know? I think there's a little bit more of a push to be collaborative with the teacher, and kind of use tools that the teacher has and or provide tools to the teacher, rather than, you know, kind of similar to what you're saying, you know, pulling the kid out, working with them on a special pencil or something, and then sending them back to their regular pencil in the classroom or something like that. That's kind of the equivalent to that. So I like that, that collaborative method, working with the parents, the kids, everyone involved, and so that they can continue to work on it even when you're gone. So, right? Absolutely, I like it. So, learn, learn play thrive is learn, play thrive.com. Right, yeah, that's it all, right. Well, Meg has a course over there that she kind of just referenced to. She is trying to train other occupational therapists out there and working with kids with autism. And she was very generous, and she actually allowed me to take the course. And it was fantastic. It's about six videos about does it total? Was it a total of six hours? It was all right. And it was very detailed. It was a lot of information. We'll get into it a little bit more, but first, Meg is actually here to give you some free information, and it's fantastic information. I can't wait for her to give this to you, and it's going to be all about how to, well, help, help children with autism. That's what she's doing with her. With her larger course, but today she's kind of here to do a little bit of a mini course. So Meg, I'm kind of kind of let you jump right into this. You know, what are some of the essential ways that we can the essential strategies, I guess I should say that we can help kids with autism.
Meg Proctor
Yeah. So one of the things that most of us sort of know about how kids with autism think and learn is we say they're visual learners, and what that looks like is we say, oh, I should probably put some visuals on the things I'm making, since this child is a visual learner, and a couple of things on that. One, yes, visual learning is a relative strength for kids with autism. There's some research, there's a lot of strong research that receptive language is a relative weakness, so our kids aren't able to make sense of what they hear as well as they're typically developing peers, and that's even true for kids with autism who can use a lot of language. There's some newer research that shows that visual learning isn't always a strength compared to their typically developing peers. It's just a relative strength, since receptive language is so difficult for kids with autism, and that's not true for everybody. You may have heard Temple Grandin say, I think in pictures, I think some of our folks with autism are profoundly visual learners, and have an incredible strength in that area, but for some it's really just a relative strength to their receptive language. So one of the things that I used to do when I worked in a lot of self contained, very young children classrooms in the schools of kids with autism and I had, like, the off brand program of board maker, I can't remember what it was called, and I, yeah, I put those, like, symbolic pictures on everything, and I felt like I was doing a good job, right? Because I was using visuals, and my young kids, you know, ripped them up or ignored them completely. And it really didn't help. And I just kept doing it because I didn't know what else to do. And one of the things that I learned that sort of made me rewind through everything I've done, was that it's really important to figure out what specific type of visual is meaningful for an individual child with autism. Just because visual learning is a relative strength really doesn't mean that those symbolic board maker pictures or clip art ever is going to mean anything at all to them. So I think it's really important to evaluate what type of visuals are going to be meaningful, and that might be objects. That's the thing that a lot of us miss.
Jayson Davies
I think you're I think you're right. And that was one of my, like, first aha moments in taking your courses, like you're right. An actual object of a ball is, like, the first visual cue that you're going to give to a child. You're not going to go to this to a photo. The first thing you're going to see, the first thing that child is going to be able to match is a red ball to a red ball, not a picture of a soccer ball. That means a red ball or something like that. So having that actual object right there with you is really, you know, that's the first go to.
Meg Proctor
Yeah, absolutely. And, and the reason is that doesn't require symbolic thinking. We're not teaching them that the ball represents something. The ball is just the ball. So I learned lots of ways to use object level instructions in my learning activities, to use objects for a schedule rather than pictures or words, to use objects for a to do list. But you know, stuff really isn't intuitive. I had to learn it, and I like teaching it to others. And then some kids can understand pictures, but more like photographs, rather than the clip, Arty kind of pictures. And then there are kids, there are kids that understand board maker, great. And you can usually tell that they can make sense of it because they use it. A child who understands symbolic pictures would be able to match the object to the symbolic picture, and in whatever context, would be able to show you that they're making meaning from the visual you're providing. I learned a lot from having a child you know my my kid at like 15 months, could look at a cartoon of a balloon and point to the balloon in the room, but that doesn't mean I could give him a schedule of cartoon pictures and he would know what it meant. You know.
Jayson Davies
Yeah, and that kind of comes to a little bit of mastery, because oftentimes in the school district, we're writing goals, and we'll write a goal for a kid to have 80% mastery and something I don't know, but we kind of this 80% ever since I started growing or since I started in schools, has kind of been like this magic number that if a kid can do something with 80% consistency that's considered mastered, how do you decide kind of where the child's master. Is and being able to identify object to object or object to symbolic image?
Meg Proctor
Yeah, that's a great question, and I think it's a really important one, because, you know, we often want to use an emerging skill for something. Let's say, like a schedule. We're like, well, they could sort of read, let's just write a written schedule. But if you imagine if I were to use an emerging skill for you, let's say you're learning Spanish, and I'm like, that's cool. I'm gonna write you're in case of emergency instructions in Spanish, and then you're on the side of the road in a rainstorm, in the middle of the you know, something very stressful is happening, and you're looking at these that you could maybe sort of understand on your best day, but now that you're stressed, it's gone right? I did not choose a mastered skill to give you your instructions. So it's so important that we don't try to pick an emerging skill just because it's easier for us, or because we have some sense that the goal is to move up and up and up. The goal is not to move up to move a kid from objects to pictures. The goal is to use whatever makes sense to that kid. So honestly, I decide what type of visuals to use through a process of assessment. Can they match objects to pictures? Can they match pictures to symbolic pictures? But then through a lot of trial and error of seeing what works for a specific activity or for a specific type of intervention, and then going back to the drawing board and changing it if it doesn't.
Jayson Davies
Yeah. And you know, as far as Spanish goes, Donde esta el banyo is, like, the only thing I got down, but I can read a visual schedule in Spanish, yeah.
Meg Proctor
I think one place this comes up a lot is with our emerging readers. And it can be tempting for teachers to use the schedule or the instructions as an opportunity to teach more reading. And I always say that giving instructions of any kind is not an opportunity to teach a new skill.
Jayson Davies
And what happens if you do it the other way around. If you're using, maybe you're using a picture of something of a physical object, and the kid can do something more, like actually reading. Does it do you ever see kind of the kid back away because you're like, you're giving me this simplistic, this too easy of a picture to see, or is it better to go safer than sorry, I guess? Or.
Meg Proctor
Yeah, that's a good question. I think that going more concrete is usually safer than going more symbolic. But I do have kids who eventually are like, I'm done with this, and then I go back to the drawing board and try something different. I'm, you know, I consider myself an autism specialist, and that doesn't mean that I make a plan and it works, you know? It means I go back to the drawing board based on the information that that child gives me from what happened. So it's a constant process of trying something, learning from the kids response, and going back to the drawing board and trying something different.
Jayson Davies
I love your definition of specialist. That's great, because it does not mean that we know everything that is for sure. All right, well, you kind of already started leading into this, I think. But the next step that I think you wanted to go over with, with what we're going over today, is teaching to the visuals. And so what does that look like?
Meg Proctor
Yeah. So one thing that that I learned, that I used to do, and that so many of us do, is we create these awesome visuals and then we teach our students not to use them. So I'll give you an example. Let's say you're in the schools, and you I'll use a schedule again. You make a schedule, and you're like, this is totally gonna help. And you put it on the kid's desk, and then you go off, and you're like, Okay, Jayson, I go up. I'll be the teacher. Okay, Jayson, time For Math. Look at your schedule. It's math time. You need to get up and go to math, right? What I'm teaching that child is that I I am going to come and tell you what to do. I am not teaching them that they need to look for the instructions. They need to look for their schedule. They need to follow the instructions from their schedule. And this has so much to do with how we prompt. We like to be very interesting and part of the activity and to get the kids attention. But our kids with autism, part of the autism learning style is that they learn routines quickly, and if we're making ourselves part of that activity, well that's part of the routine. I sit here until Miss med comes in with her big, bubbly voice and tells me where to go next and points at the schedule, and then I go. So we have to be really careful with our prompting, to make sure we're teaching kids to use the visuals, not teaching them to use us.
Jayson Davies
That's funny that you say that actually, because right as you were saying that I this kid popped into my head, and he's this type of student who he knows. He's very aware. Here he has autism, but he's very aware, and he when he does something bad, he will then prompt his teacher to say, Don't do that. Like he wants that that routine from the teacher to tell him that you're not supposed to do that. And he will literally prompt his teacher. He'll say, teacher, tell me, don't do that. And then the teacher will have to say, yes, yes, student, don't do that. It's like he knows that he's not supposed to do it, but he has developed that routine. And like you said, she she's a very animated character, and so he gets a kick out of her responding and telling him not to do something. And so if, maybe if she kind of toned it back a little bit, became a little bit less animated and relied on the visuals that she does have for that student, it could go a different route.
Meg Proctor
Absolutely, I remember a student that I had my second year in the schools who was a middle schooler with autism, and he had had a lot of behavioral therapy with a lot of reinforcers, and he was very bright, but if he answered a problem like on a Math Worksheet and you didn't say, good job, he would erase it and look for a new answer. And that's kind of what I always pictured as prompt dependence, because that's the extreme, but, but we all do this in our own way, even if we're not, you know, handing out candy for right answers. We're doing it with our faces and with the way we're prompting. We're teaching kids to look to us. Still.
Jayson Davies
Definitely All right. So we went into kind of some gestures versus verbal prompts. One of the notes I took during the course was air free learning. What do you mean by air free learning when it comes to visuals?
Meg Proctor
Yeah, so when I say that we want to prompt differently, I don't mean we want to just kind of throw our kids out to the wolves, right? Like, you know, you just said gestures versus verbal prompts. I'm going to use a lot more pointing and helping them look to the visuals, and a lot less trying to get their attention to me. And let me be clear, I'm talking about when the goal is for them to access their visual instructions independently. I do a ton of work on social engagement, and those are the times I want them looking at me. I want that engagement. When I'm teaching a child to follow instructions, it's not about them engaging with me. It's about them engaging with the instructions. But I don't want to just like point and hope it works right. So there's a lot of good research showing that our kids learn, our kids with autism, learn best by getting something right the first time, rather than by making a mistake and having us go that's wrong, and that probably relates to the routines and to the receptive language piece. So I will jump in before a child makes a mistake and give them as much support as they need to get an answer correct or to do a process correctly the first time. And then I'll be really intentional about fading out how much I'm supporting them and how much I'm prompting so that that isn't the routine. The routine is they're learning how to do the activity and how to do it correctly.
Jayson Davies
Gotcha. Yeah. And so do you have a hierarchy of prompts a little bit? I don't know if you so obviously verbal. I well, I don't know what's the highest level of prompts that you would use or that you consider the most restrictive or the most needy prompt for a student?
Meg Proctor
Yeah, I think doing part of the activity for or with them, so physical assistance I don't do hand over hand. It's not it's not philosophically comfortable for me to move somebody's body, but I will hold a material with a child. I work with a lot of young kids, so if we're doing like a shape sorter, I might hold the block with them and help them get the block in. So I think that that type of physical assistance with permission from the child is the highest level.
Jayson Davies
Yeah, I agree with that. I I can't stand hand over hand, either. And especially working in the schools, there's so many things that can go wrong. And you know, I think all OTs have to deal with this, but even more so male OTs, it's just being in the schools. We have to be very careful of you know, what prompting is going on. And so, yeah, I just kind of stay away from the hand over hand prompting as much as possible. Of course, there are times that it is needed, but it's kind of that very much only as needed. You know, we want, like you said, we want to set up our kids to be successful and and be engaged, and how engaged are they really when we're doing hand over hand prompting? So absolutely, yeah, all right, well, I think the next step that you have listed here was the informal assessments. And so we all of course, do you know in the schools, we often use the bot to. The M fun, the rabma, things like that. But a lot more OTs, I think, are using informal assessments, because we can, we need to be able to see the actual routine that the kid is doing. Is that similar for you? You're trying to see the actual routines that the kid might need to do in the home.
Meg Proctor
Yeah. Yeah. So I think that our kids are our best teachers. So we can know all kinds of things about autism learning styles and about whatever the occupation is, but if we're not actually watching that particular child do that particular activity, we're really missing an opportunity to learn from them about what they need from us to be successful. So you know, if I think about again, one of the things I used to do in the schools as I'd get some sort of goal for a kid to like color in the lines, and in my first session, I would start teaching. And what I should have done is start with an informal assessment. Same thing in the home. I don't know if, if you guys have these uncomfortable conversations with teachers that I've had with parents, where you're like, making suggestion after suggestion after suggestion, and they're going, yeah, we've tried that. It didn't work. Yeah, we've tried that. It's embarrassing, it's a waste of time. And you know what we're really missing? Well, there's several things missing in that example, but one of them is that process of informal assessment. Show me what's happening now. Show me what you've tried. What would you like this to look like? That's if you're working with a caregiver or consulting with a teacher, but really just sitting down and putting the materials out and seeing what the child does without you teaching here, I'll use my least to most prompting. So if I put those crayons and the paper down and they don't do anything, I'm not going to end my informal assessment, because I've learned something, but I haven't learned enough. Yes, I might then give a prompt color the picture, and if they still don't do anything, I might hand them a crayon. And if they still don't do anything, I might start coloring and then hand them a crayon. But now I'm really learning, okay, what does it actually take for this kid to get started and understand the instructions, and then what do they do? But if I just started by giving a demonstration and handing the crayon, I have no idea what their baseline is.
Jayson Davies
That's true. That's very true. I like that, yeah. Because, again, going back to the different types of prompts, you know, we sometimes will jump jump ahead, just for the sake of time, or for the sake of just getting an assessment done to get it done versus getting it done to really understand what the child can and can't do. And so like you said, we will skip ahead and we'll just give the kid the crown, or we will just or even go further. And like you said, We'll color for them and then have them color, versus just seeing what will they do with the crown, or what will they do. And so we need to take that step back.
Meg Proctor
Yeah, and this isn't just something that we should do during the actual evaluation. It's something we have to come back to time and time again to see where we're at. For me when I work with field work students, or even in my own practice, when I feel stuck, when I'm like, I have this goal and I don't have any idea where to start, it almost always means I haven't actually done an informal assessment, because we can't come up with interventions in the abstract or not really. I mean, if you're working on the same thing over and over, you might sort of be able to, but when we feel stuck and then watch something, it's like, oh, that's where you're stuck. It's not just I'm supposed to teach you to brush your teeth or cut on the line. It's I'm supposed to teach you to sequence the stop Sure. I'm supposed to teach you how to turn the paper right. The other opportunity we miss when we don't do informal assessment is sometimes we miss the opportunity to see that we're being successful. I do some one on one consultation with therapists, and I had a therapist who was working really hard on teaching play, and she finally sat down and did this very structured play session, and it went awesome. And she was like, did I maybe he could already play? Maybe, maybe that was unnecessary and, and I don't think that was the case. I think that she hadn't started with an informal assessment, so she couldn't see that her intervention was what created the success.
Jayson Davies
Yes, no. And, you know, I just started a new school district this year, and so, you know, my caseload of 55 kids, or whatever I was brand new to, and I didn't do their initial evaluation, or their recent triennial evaluation or whatever. And so that's kind of the first thing I really had to do is, you know, meet the kids and then kind of do that little informal evaluation, because I'm walking into these, into these IEPs. Or looking at their documents, and, you know, they have two or three goals that I'm supposed to be working on. And of course, I've never met the kid. And so, yeah, that's kind of where I started, too, is with a little bit of an informal play, slash, I mean, yes, it was play for the kid, but for me, it was an informal evaluation to see where they're at and kind of what that next step is. So one of the things I think OTs sometimes get flack for is not taking data. And I think through that informal, occasional informal assessment, you can kind of get a little bit of data that helps you, helps you, not only reason, but also helps you, show the parents or show the teachers or show the parent advocate or whatever, what progress has been made come time for progress reports and the annual IEP? So, yeah, I think we all need to be doing more informal assessments throughout the course of the treatment, because we do need to kind of see that progress, like you said. So All right, so what's next?
Meg Proctor
Well, I sort of mentioned this when you were asking me about how to figure out what type of visual to use for a kid. And this is the idea of when something's not working, going back to the drawing board and restructuring our intervention. And I think this is important enough that it's worth, you know, tackling as its own strategy, because what we often do as therapists is we develop an intervention and then we teach it, and if it doesn't work, we teach it and we teach it, and we teach it and we teach it more. And that is especially true if we spend a lot of time making it and we laminate it. I'm going to use this intervention, and this really ties in with the informal assessment. If I were teaching a child to, I know an activity I've seen a lot in the schools is the one where you teach a kid to, like, organize the letters of their name into order. I would make that really quick and dirty and do an informal assessment with how they do with it, because I might learn, oh, this child wants to Velcro on top rather than underneath. Or this doesn't make sense at all to this child, but I know he likes activities where he can put something in. So maybe if I make it into a put in activity where it says j, A, y, s, O, N, and there's a little slit, and he's going to stick the letter in the box, I can do or, you know, I could learn any myriad of things from trying this activity, seeing what the child tells me. They throw it on the ground. It doesn't make any sense to them. They do it incorrectly and then restructuring it to make it more appropriate for that child's learning style, rather than insisting that they learn the way I have created the activity which is frustrating for everybody.
Jayson Davies
Yeah, I like how you I mean, we're constantly restructuring. That's kind of why we have this job as an occupational therapist and as an OT the different ways that we can restructure include not only what we've been talking a lot about today, the visual instructions, but also changing the environment. And so how are some ways that you've changed the environment?
Meg Proctor
Oh, absolutely, yeah. You know, if you find that you're in a session with a kid and your whole job is just trying to get them back to the table. I know I have lots of those. I try to see from the perspective of the child, that that the environment speaks to them. So are they staring at the wall of toys where they're sitting? Are they sort of in an open space in the middle of a room? I've worked with a lot of more concrete younger kids who when they're kind of in a little nook, not trapped at all, but like there's some furniture on either side of them, and they're sort of nestled at their little table space. That space says to them, Hey, stay here. Like there's nothing else calling to them. And one time, just as an experiment, I took a kid where that was going great, and I put the table in the middle of the room, and she literally ran in circles around the table the whole session, because that's what the space was saying to her. So, you know, this is again, somewhere that we want to think about. What makes sense to a child, the like blue tape on the ground to say, like, here's where you're supposed to be, maybe. But that's super symbolic. You know, the mat to stand on, maybe for some of my kids, actually just rearrange the furniture so that the space is like, hey, rest of the room is boring. This is where you're supposed to be.
Jayson Davies
There you go, Cool, all right. And then I think this was my favorite part that you wanted to talk about now was actually expanding the occupation. And I work in a high school, and so we've been doing community outings and stuff, which this is kind of my focus point right now, is expanding their occupations that they're learning in the classroom out to different environments. So what does expanding the occupation mean to you?
Meg Proctor
That is so awesome that you get the chance to. Do that that's so important. Well, you know, we always give this like token reference to our you know, kids with autism have trouble generalizing, so we have to help them generalize. But what I find is that more often than not, we kind of forget or don't get around to actually doing it. And that can mean a lot of things. One, it can just mean teaching a skill with different materials. So okay, you can sort by color with the little bears. Can you sort by color with chips? Or, let's see, I know so many of my examples are for young kids. You can solve these math problems in in this room, you do it in this other space with this other teacher. You know, because our kids are are forming routines around what they do and where they do it. So we want to make sure that they can use their skill with different materials, in different places and with different people, and I don't I don't usually start there. I don't usually start if you're teaching a child or cycling. I don't usually start by going out to the community where it happens. Because what I know about the executive function piece of autism learning styles is it's hard to figure out what to pay attention to when there's a lot going on. So I'll teach with learning activities at the table, where I know I can help the child see the main point versus the details, learn the activity, and then I know I need to explicitly work on generalizing and helping them get out to where they're going and use that activity there, and then make sure they can do it with their teacher, not just with me make sure that they can do cans versus cardboard, not just cans versus bottles. So making sure whatever skill I'm teaching they're able to do it in different places, with different people and with different materials.
Jayson Davies
Yeah, definitely. I think that's one of the biggest things that when I get pushed back in an IEP, especially a more high profile IEP, where there's an advocate, or something like that. That's often the first question that, one of the first educated questions that I will get is, you know, okay, you said this child met their goal in? What environment did they meet their goal? And so well, if I say they met their goal in a one on one setting, in the therapy room, and, you know, this kid's occupation is to be functioning in the classroom. Then, did they really meet this goal? Well, not really, because they're only with me, you know, 30 minutes once a week versus we need to make sure that they're meeting all these goals in the classroom, where they're supposed to be accessing their education, or on the playground, if that's where the social difficulties are, or wherever the actual occupation is taking place. And so, yeah, I completely agree that we need to be expanding that outward. We need to be helping these kids in their natural environment, not just in that therapy setting. So yeah, so any other tips and tricks that you want to give a quick shout out to? I don't know there something on your mind?
Meg Proctor
No, I have so many I could, I could ramble on and on, but those are the I have, those five, sort of laid out in the little free eBook on my website and in a bunch of Facebook Live videos as well in my Facebook group, OT and autism. So I'll, I'll stick with that for today.
Jayson Davies
Sounds good, and we'll be sure to put all all the links to those various sites on on our show notes. So that was at learn, play, thrive.com. You also mentioned your Facebook group, which I know I'm a part of, and so we can put a link to that. And was there one other thing? Oh, well, you mentioned the Facebook videos that you have that are on your Facebook, yeah. So, yeah, no problem. We will definitely put some links up to those. So again, thank you for learning, for allowing me to learn all of those tips, plus many more in your course. That was super, super helpful. All the activities that you have kind of fit right into the course. I love some of the little the little animated videos that you had for your case studies. Those are all fantastic. I enjoyed those. So one thing that I wanted to ask you is I learned so much in that course. What do you feel that these strategies can be geared toward kids who don't necessarily have autism? Or do you feel like these are pretty autism specific?
Meg Proctor
That's a great question. So I think that when we are working with a child, we need to think about that child's learning style and the strategies that I lay out in the course have to do with how kids with autism think and learn. So if you are working with a child with a different strength and a different set of differences and. You might want to use, you might want to tweak what you're doing. That being said, there's a lot of similarities between learning styles with ADHD and learning styles with autism, especially the executive function piece, and also often some of the rigidity. And I know in the schools, you see a lot of kids with autism and with ADHD, and these strategies are very effective for students with ADHD, as well as students with autism. I think some of the principles are important no matter who your student is, but I think it could be sort of a sticky trap to think that you know visuals are going to enhance every child's learning when you might have a child who's really a poor visual learner who doesn't have autism, so just really individualizing and thinking about, okay, what is this child's strength and what is their learning style, and how can I tailor what I'm doing to them?
Jayson Davies
Yeah, I want to ask you one question is kind of a specific question, but, and if it doesn't work, it doesn't work. But, so I made a visual schedule for this kid's morning routine. And so you know, it's Get out your backpack, put your lunch wherever it belongs, turn in your or get out your homework, turn your homework, and then he actually goes to the RSP classroom at the end of his the end of the schedule. And so we made it so that he can completely just cross everything out. And this is a little older, I want to say, like third grade kid. And so he can read. He can do stuff like that. So it's a little symbolic picture with with some language or with some words on it. My problem, though, is that he won't often initiate it until, like, if he sees me, like, sometimes it got to the point where I would kind of just stop into his classroom real quick, just so he could see me, because that gave him that prompt to start that cue. So just based on that limited information we do, you have a recommendation that I could potentially try?
Meg Proctor
Yeah, yeah, that's interesting. Initiating is hard, so one thing that you could try is to have a pencil that he always uses, maybe that has like a little flag on it that says check schedule, or has a little picture that represents the schedule, and have that maybe velcro to his Cubby, where he puts his backpack, whatever routine he has. So you'd want to teach him the routine of like hanging his backpack and then grabbing the pencil, and then it's the pencil that's going to tell him you're supposed to go to your schedule. And that's not going to be meaningful to him right away. You have to teach it. But again, you're going to be teaching in a way that you're boring, you're pointing, you're silent, if you can be and you're fading yourself out so that he's learning to come in he's backpack, look for the pencil. For that pencil to tell him to go to his schedule and to get started from there. Sometimes having something physical to carry and do can be more compelling than just like a routine.
Jayson Davies
I do like that idea because that's already part of his natural routine. Is to put his is to put his backpack down, and so if that that object, or whatever it was, was right there, he would see it as he's doing it, and it would just be a continuation of already a current routine that would just kind of lead into the next thing. So I like that idea. Good job. I put you on the spot, and you succeeded. Good job.
Meg Proctor
Well, you know, do your informal assessment, you might have to restructure that very true,
Jayson Davies
but it gives me a place to place to kind of start with. So yeah, I appreciate it. All right. Well, Meg, I definitely want to say thank you for coming on the podcast. It was, it was great having you talk about so many different areas that can help our kids in the schools, or for any ot that might be working in, like you, early intervention or in the in the other areas pediatrics. But before I let you go, I want to ask you, you know, I took your course, I learned a lot from it, but I want to hear from you, what do you feel like, what are people going to get out of your course? What do you hope that every therapist that will take your course will will learn?
Meg Proctor
Yeah, so there's a whole lot of content. It's things that I probably learned five or six times before I stopped getting something new every time I learned it. So I think no matter what your level is, you're going to get something different. But I really want therapists to have a framework that lets them consider autism learning styles really in depth. Consider autism learning styles, not their visual learners, but have a really deep understanding and appreciation of the complexity of how a person with autism thinks and learns, and actually use that to help us shape our interventions. You took the training. It's not there's not much theory, it's a lot of practical applications. So I want people to have these frameworks that they can use and then individualize for their particular learner.
Jayson Davies
And today we talked a lot about a lot about visuals, but what else is in the course that you enjoy talking about?
Meg Proctor
Yeah. So I go deep on autism learning styles. I teach a behavior problem solving process, and I have sort of a work book that folks can go through on their own or together with teachers. And that's the process I use in my own practice. It gets me better, more relevant hypotheses and interventions every time to make a behavior plan that's not like, oh, the child obviously wants attention. Like, that's not usually a super relevant hypothesis. Teach them how to think about what is causing a behavior. From the perspective of autism, we do schedules, we do visual to do lists, which is, you know, everything can't go on your schedule, and when we try to put everything on a schedule, it gets kind of complicated. I think the longest module is actually about play and leisure, which is so, so important to all of our kids. Talk about self care, and then at the end, we tie it all together with how we can take these skills and help our kids be successful moving out into the community. So each of those modules has a whole lot of content, a lot of specific examples, a case study, and then an opportunity for the therapist to apply the knowledge to their own practice and come up with a plan they can use right away.
Jayson Davies
Absolutely. And the last case study really made me think you kind of, in a way, forced us to give you multiple hypothesis as to why this behavior was occurring. And like you kind of said, you know, the first thing that came to me, the first hypothesis, was attention seeking. But you know, you kind of, and typically, I would stop there. I mean, I might see a kid doing in my informal observation, I might see a kid do something. I might think, okay, that's attention seeking. But because we had it on paper and the way that you structured that that worksheet, it made us come up with another and another hypothesis. And I think my third hypothesis might have been just amazing compared to he just wants attention. And so by forcing us to kind of go through all the different hypothesis that may be possible our hypothesis, it just kind of makes you think a little bit deeper, a little bit more outside the box, and you kind of come up with conclusions that you wouldn't have come up with without going through all the steps that you lay out in that mostly that last course, the the community based learning or generalizing, I should say, and so. So yeah, I want to say thank you so much for coming on the show. Thank you for allowing me to take the course. For anyone out there who who wants to take the course, I highly recommend it. And I actually, I'm going to let me tell you where, where you can learn more about the course.
Meg Proctor
Yeah. So if people go to learn, play thrive.com, and click on the the four therapists part, they'll see a link to the course. It opens for specific enrollment periods, I like to kind of work with my therapist through the course and be there to support them. So I do have it open right now at the beginning of January, and I am enrolling new students in the course, and the enrollment period will close, but it'll open again in a couple of months. So I'd love to give your listeners a little bit of a discount just for being awesome and listening to the podcast, so they can use schoolhouse 25 schoolhouse all one word and then the number 25 to get $25 off their enrollment in the online training or the live training if they happen to be in the North Carolina area.
Jayson Davies
That's where you're going to be. North Carolina. Very cool. Yeah, awesome. Well, thank you for that so much. That was unexpected. I appreciate that it's kind of fun when you're able to come on and help our listeners. So I appreciate that so much. So yeah, definitely be sure to check out Meg's website, at learn playthrive.com and also she has a Facebook group, right? You have a Facebook group?
Meg Proctor
Yes, absolutely. Please join the Facebook group on this is where people come to ask questions. We problem solve together. I'm always coming on and doing little mini trainings via Facebook Live that aren't also on my website. I make announcements in the Facebook group when I open new training. So that group is called OT and autism, so if you search for it, you'll find it. And we'd love to have you there.
Jayson Davies
Perfect, yes, and definitely join us there, because I'm in there too. And so it's a fun group to be active in. And and Meg is awesome, because she does just come on like, I feel like I see your face coming on a live video once a week, or at least once every other week or so I see a video up there, it seems like, and so it's very nice that you do that for everyone in the in the group. So, yeah, well, thank you so much for coming on. I appreciate it. And I hope everything's going well for you. I think, thank you. Yeah, thank you also, again, for allowing me to take the course. It was so much fun and so much information that I learned, and I'm already using it. I mean, even the visual schedule that I created was like, smack dab after watching whatever module it was in your video. And I'm like, You know what? I don't need to be perfect. I can just kind of make a simple visual and try it out and see what happens.
Meg Proctor
Oh, I love that. That's like, one of my favorite takeaways is, everything doesn't have to be perfect. It doesn't have to be beautiful. Let's just try something exactly that's awesome.
Jayson Davies
You made an influence on me. So thank you so much. But yeah, so All right, well, we will say goodbye, and I hope you have a good 2019.
Meg Proctor
Alright. Thanks. Jayson, bye, bye.
Jayson Davies
Alright. Well, that was Meg Proctor of learn play thrive.com and of the OT and autism Facebook group, be sure to check out learn play thrive.com the course is currently open here at the beginning of January, and like she said, she opens it and closes it periodically, because she likes to be very intimate with the few amount of therapists that she really allows into the course. So be sure to check her out at learn, play, thrive, or it sounds like she's also doing some live sessions now of her training. So if you're on the East Coast in North Carolina, be sure to check those out too. She's very much a animated character, and she's great to learn from, so be sure to check it out. Also be sure to check out ot schoolhouse.com, forward slash episode 21 for any of the show notes and links and a copy of that discount code so you can get over and get $25 off of her course. All right, everyone. Well, take care, and we'll see you next time on the OT school house podcast.
Amazing Narrator
Thank you for listening to the OT school house podcast for more ways to help you and your students succeed right now, head on over to otschoolhouse.com Until next time class is dismissed.
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