The use of help cards for children with SM can be controversial as some feel that it is enabling the child to continue avoiding speech. From my perspective I find them very useful in lowering the child's anxiety about things that may happen as a result of their inability to communicate their needs. E.g. not having to worry that they will wet themselves because they can't ask to go to the toilet. Cards are therefore a temporary accomodation. Here's how you use them and as a bridge to speech rather than an enabling thing:
1. For children who can't yet read well- use cards with pictures or symbols on them as well as one simple word. You need things like: toilet, hungry, thirsty, sad, wet pants, tired etc.
2. Make several sets of help cards as they will lose them. They are best off laminated and kept on a ring. You can keep a set in their drawer, in their bag, give one to the teacher, give one to each specialist subject teacher if they have them. Then they can also keep a set in their pocket or on a lanyard if they are comfortable with that. The other option for really little ones who perhaps don't have the patience to leaf through cards is a laminated board with all options on and the child can point to the need or state.
3. How will they get the teacher's attention to show the cards? They may not be brave enough to queue up to show the cards. Ask the child what they would be comfortable with. Maybe a sign or asking a friend to go with them. Hopefully the teacher is sensitive enough to notice and approach the child first. Once that becomes easy you can then continually set and reward new goals e.g. putting up your hand for help, queuing up for help.
4. Each time they take a first big step I find it easier if the parent or support person is there to nudge them along. You can rehearse in advance : 'Ok so today we are going to use your cards with Mrs Wilson. I will go with you and queue up to show her your toilet card when you need to go. Then you will get 4 stickers on your chart and a chocolate frog when I pick you up!'. Then stay and practice the new thing several times, giving a sticker for each repetition. Don't expect them to be able to practice once with you and then that's it. Continue to reward them heavily the first few times they initiate use of the cards themselves. Then 1 sticker for each use. Each time you up the difficulty level, go back to heavy rewards for the first few times.
5. As soon as the child can read well enough, make the cards more complex so that their needs are better met and they can express themselves more fully. We've included things like: 'Someone upset or hurt me' and 'I need a buddy for recess' and then each child's name in the class so they can point to the name. We also put things like 'I can't find my....' and then on the other side a list of things they might have lost. We also put more open ended things on there like 'I am worried about something' so then the teacher can try and draw out what the worry is, whether using a whisper buddy or writing it down or nodding if the teacher guesses correctly. We've also made cards for our daughter to use with her friends that say ' will you go with me to ask for help?' 'thank you' and 'please can I play with you at lunch?'
6. Whenever the child is finding the use of cards easy, make it a little bit harder e.g if the child is already verbal with the teacher when no one else is around, the teacher could take the child into a quiet corner and see if they can repeat one word that is on the card. You can use humour too. E.g. 'Saskia, I can see that you have a help card there. Let's go in the corner and see what it is. Oh, do you need to go to the toilet or do you need to tell me there is a hippo on the oval?' Saying just 'toilet' or 'yes' can then be heavily rewarded. Or even just sounding out the letter T for toilet.
7. Another way of making it harder is instead of responding to what the card says each time is to get the child to whisper what is on the card to a friend. Gradually over time the whispers get louder so the teacher can hear. I prefer not to use just a whisper buddy and no cards because if their buddy is away or they have had a falling out then they are stuck. They can also become too dependent on the buddy. With the cards they are initiating it themselves but can still use a friend for help too.
8. Make sure that the teacher doesn't spring new challenges on the child. It needs to be planned in advance. They might take a quiet moment and say: 'Nathan, you have been doing so well with using your cards all week. Do you think you would be brave enough next week if we go in the reading corner and you could sound out the first letter to me for 4 stickers on your reward chart?' If the child looks really stressed then find another challenge that they think they might be able to do. It could be something as small as sitting closer to the group on the mat instead of hiding away at the back. Or using the cards with a relief teacher.
9. Different children find different things hard. Some might find signs easier than cards, but for most children cards come first then signs, as signs are more expressive and there is also some performance anxiety about doing the sign 'wrong'.
This is an old Facebook post which was one of my most popular ever, so I'm re-running it, but some of our circumstances have changed. I'll add those in a comment at the end.
Living with anxiety is exhausting, especially for young children who are already exhausted after a day at school anyway. The nature of SM means that children rarely show their feelings during the school day, so what is bottled up tends to come tumbling out when they get home.
Dinner is always late in our house because it takes at least an hour and a half before I can even think about making dinner.
Here are a few things that have helped us to cope with the inevitable after school meltdowns. Every child is different so they may not work for your family. I keep saying 'she' and 'her' instead of 'they' because my big one is now fine and transitions smoothly between school and home. My little one also has epilepsy which affects the quality of her sleep, so for her, even though she is over the worst of the SM, I still anticipate having these problems until she (hopefully) grows out of her epilepsy.
* I've given up asking questions or making conversation in the car on the way home. My daughter prefers silence and if I talk to her before she has 'decompressed' it just causes arguments. The bad mood often then starts before we even get home!
* Even though I'm desperate to know how her day went I usually save the questions until after dinner as she seems to have recovered by then. I also ask questions in a round about way so it's not obvious that I am anxious about her anxiety!
* The first thing we do when we get in is sit down and snuggle together while she eats anything that is left in her lunch box. I usually put in more than she needs so that it is right there ready and then we don't have to wait for me to make a snack.
* Protein & fat will stabilise blood sugar and mood after school much better than carbohydrates.
* I make sure she's drunk all of her water from her water bottle and then refill.
* Going to the toilet is not optional after school. I enforce a 5 minute sit at least. Then another one after dinner. This is because SM kids often won't poo at school, some won't even wee and/or have accidents. You don't need constipation as well as everything else.
* I find that going in the bath before dinner seems to wake her up and snap her out of her funk. Mood can change instantly after a bath it seems. If she is having a meltdown where we can't even manage a cuddle & snack then it's straight into the bath and eat in the bath!
*Once she is in her PJs, depending on mood - she might play outside or read or watch TV. If I'm expecting her to do any kind of chores like unpacking her bag, putting her shoes away, putting her school uniform in the wash basket and feeding the pets, then I don't allow any TV until those are done.
* That takes us though to dinner, shortly followed by bed.
* If we are having difficult behaviour even after getting into PJs then I might encourage a quiet time in her room listening to an audio book or meditation, more snuggling with me, more snacks or just ignoring her.
* If things are really bad then I initiate a 'Code Blue' which is get ready for bed immediately upon coming home from school, scrambled egg or beans on toast for tea, a long story and wind down with Mum, then in bed by 6.30/45 pm
* The only thing that has speeded up our evening routine is I have made a laminated list of after school jobs and I expect her to do all or some of it on the days when she is not too tired. Then I can get on with dinner sooner. More often than not she is too tired to do much. I know for most kids it's pretty basic to at least unpack your school bag but I don't worry too much if she doesn't do it, as long as she knows how to be independent on the good days.
* Young kids with SM will probably be too anxious to be picked up at the gate (kiss n drop - or whatever it's called at your school) but if Yr 1s and above are able to work up to it, if you have a drive by pick up area at your school, then oddly this has worked really well for us. My little one is not anxious about it because her big sister picks up her up from her class and walks her over to the gate. I used to find that the walk from the classroom to the car (which is quite long and busy at our school) was the time when the worst meltdowns began. The heat (or rain), the crowds, the noise, the heavy bag and the chance to push back against Mum were just too much for her. Walking to the gate is way less stressful for her and she gets to decompress in the shade with her sister & friends for 15 minutes after school. Obviously as a parent of an SM child you can't do that every day as you want to keep an open line of communication with the teacher, but I find that only going in when I have a meeting reduces my frustration too at the amount of time I spend at school ( which is a lot with mornings, meetings and facilitating her support work).
Hope that helps some people!
Update: 02 May 2017 - after school behaviour is much improved in our house, but there are still bad days, weeks and months! Completion of the after school list is gradually improving. We now have a puppy and I try whenever possible to bring him on the school run with me. Having him sitting next to her in the car definitely lowers my daughter's anxiety / overwhelm before and after school. In the winter I find that it is waking up which is more problematic than after school. During terms 2 & 3 we get up half an hour earlier and the girls have their bath then. The bath is already run and the fire is on with their school uniform laid out in front of it before I wake them up. It's a much nicer way to ease into a winter morning and seems to reduce the amount of GET READY shouting from me!
Posts coming soon....