Grandma Tina has been a listener and follower of my programs for a while, and has aspired to become a “Gung-Ho Grandparent”, after this conversation I certainly think she is. Tina is the grandma to 2 and a half year old Wyatt, who was diagnosed with Global Developmental Delays at 13 months and autism at 19 months. Since then, Tina and Wyatt’s parents have been applying my course work and ABA therapy and have seen some major successes. Today we go over Wyatt’s One-Page Assessment and we discuss his strengths as well as some key issues they are looking to overcome.
Feeding Issues and Autism
The advice in this episode is purely for information purposes and I encourage families to rule out all medical issues before continuing with any feeding program. Wyatt eats only smooth baby food fed directly to him and drinks only water squeezed out to him through a straw. Tina shares that they do in fact already feed him from containers other than a labeled jar but is willing to try my suggestion on feeding from styrofoam cups or another container that will block the ability to anticipate color or consistency before being fed. We also discuss trying a thicker, chunkier consistency, as well as moving to real food puréed at home as a next step. Wyatt is currently able to hold a cup but is unable to drink from the straw independently, I suggested sports cap nozzles as well as introducing juice as a sweet encouragement to suck from the straw. Tina and the family have listened to the episode with feeding specialist Dr. Keith Williams and have even been successful with solutions he has offered to them.
Language and Self-Care
Wyatt currently has some language, Tina and I talk about his clear and unclear words and turning them into Number 1/ Number 2 words lists that clearly outline and define the words Wyatt knows or is working on. Wyatt already has a great deal of strengths that contribute to his success in learning language, he participates and enjoys table time and imitation but he struggles with allowing hands-on prompting. This creates some issues when it comes to learning self-care tasks, such as self-feeding, handwashing, teeth-brushing, and getting dressed. The best thing to do when prompting for these skills is to come from behind the child, working with them the same way they would independently. Also, make it fun, pair videos, songs, etc. to get the child excited about what they are doing.
Grandma Tina On The Turn Autism Around Podcast
Tina is a grandparent to Wyatt who was diagnosed with global delays at 13 months, and ASD at 19 months. She found my online courses when her grandson was 13 months and began table time. Currently, Wyatt has 13 hours of ABA therapy per week. Three days a week at his house, and two days a week at his grandparent’s house. They do table time any day that Wyatt is at their home.
Tina is passionate about working with Wyatt and his family to get him the therapy he needs and continue to see progress. She urges other families to communicate and collaborate together with each other and with professionals for the best interests of their child. Not only is she able to learn from me by taking my course but by listening to this podcast she has expanded her resources to the many other professionals who have been featured and the great information they have to share.
This episode is Hot Seat #5 and I had special permission from Tina and Wyatt’s parents to discuss him and his case by name. You can find any of the assessment tools we discussed in today’s episode in my book, Turn Autism Around, or through the courses.
- How involved grandparents can make a different in a child’s therapy and progress.
- What are Global Development Delays?
- Ideas for improving feeding issues.
- Ideas for encouraging self feeding and drinking.
- Ideas for improving specific language skills.
- Ideas for prompting self-care skills.
- The importance of collaboration with parents and grandparents and professionals.
- Turn Autism Around®️ – New Book from Mary Barbera – Autism Mom, ABA Help for Professionals and Parents
- What Shamu Can Teach Us About Training with Amy Sutherland
- Dr. Keith Williams: Tackling Selective Eating in Children with Autism
- Diagnosing Autism: An Interview with Developmental Pediatrician Dr. Cheryl Tierney
- When To Tackle Weaning Off Pacifiers with Pediatric Feeding Specialist Melanie Potock
- Pacifier & Bottle Weaning for Children with Autism in 6 Easy Steps
- Dr. Missy Olive: Medical Conditions Associated with Autism
- Speech Articulation Problems in Kids with Autism
- Building Imitation Skills in Toddlers with Autism or Showing Signs of Autism
- Talk Tools & Speech Therapy for Autism with Mags Kirk
- Wyatt’s One Page Assessment
- Wyatt’s Language Sample
- Wyatt’s Self Care Checklist
- Wyatt’s Planning Form
Grandma Tina – Turn Autism Around Podcast Transcript
Transcript for Podcast Episode: 174
Global Development Delay and Autism: Hot Seat #5 with Grandma Tina
Hosted by: Dr. Mary Barbera
Guest: Grandma Tina
Mary: You're listening to the Turn Autism Around podcast, episode number one hundred and seventy four. Today we are doing hot seat number five where I am interviewing Tina, who is a grandmother of a little boy with autism. He started out with a diagnosis of global developmental delay, and his big areas, which we cover pretty extensively, are in the areas of feeding. He is eating baby food only at this point. So we talk all about some feeding ideas. He's talking, but some of his words are unclear. So we talk about how to get those words improving on articulation and how to get his language expanding. And the third thing we talk about is self-care skills, which is, you know, hand-washing, toothbrushing pulling up and down pants, drinking and eating himself without being fed. So we talk all about the four step turn autism around approach, and I give specific ideas to improve in those three areas. It's a great episode. Hope you love it as much as I did. Let's get to this interview with Grandma Tina.
Narrator: Welcome to the Turn Autism Around podcast for both parents and professionals in the autism world who want to turn things around, be less stressed and lead happier lives. And now your host. Autism Mom, Behavior Analyst, and bestselling author, Dr. Mary Barbera.
Mary: Tina, thanks so much for joining us today. I'm excited to talk to you to do our hot seat number five.
Grandma Tina on the Turn Autism Around Podcast
Tina: Thank you, Mary, I'm so glad to be here, thank you so much.
Mary: Awesome. So why don't you tell our listeners and me about your fall into the autism world? Is that just something that happened as a grandparent or did you know about autism before? Just kind of like, how did you fall into this world?
Tina: I knew the word autism. I maybe knew a little bit about it, but not very much. My grandson was born in September 2019. I retired January of 2020, course then we had a pandemic. And when he was about six months old, he was clicking along fine and six months old. But at his nine month appointment, the pediatrician was asking my daughter in law several questions Is he doing this or is he doing that? Is he doing this? And she was answering, No, no, no. And she said, Is he supposed to be doing all of these things? And he hadn't been around other babies with COVID and they hadn't been they didn't know, typical from non-typical. None of us did. And so anyways, his pediatrician suggested a developmental pediatrician. And so our family got together, started searching. My daughter's sister in law is a pediatrician. She went to Vanderbilt Medical School, and so she had colleagues here at Vanderbilt, and she helped us to find a developmental pediatrician that specialized more so in Wyatt's young age. And what seemed like a long time then, but now I know, wasn't in about four months and about four months time we had an appointment with that developmental pediatrician. At that time, he was diagnosed with global delays.
Mary: And that was at what age?
Tina: 13 months.
Mary: Global delays at 13 months and then that same developmental pediatrician diagnosed with autism or?
Tina: At 19 months, yes, six months later. OK. Yes, in the meantime, then I started going online and just basically researching initially global delays. I started seeing the word autism. No one started researching more in that area because then signs were more apparent and I could sort of see, you know, that maybe that was going to be where we were. And so. I found out about your course and I watched the video, and I was also sort of in the process of picking myself up and saying, you know, it's time to do something, you're retired. My husband had also retired by that time. And we've got time. We've got some abilities. Let's get going on something, you know? And so I got your toddler course in at about 14, 15 months. We started our little couple minute version of table time.
Mary: Wow. So you became a gung ho grandma like our grandma episode. I forget the number. But you said before we started hitting record that you had watched that and you had hoped that someday you'd become a gung-ho grandma and look at you, you have, right?
Tina: Well, thank you. That's certainly my aspiration for sure.
Mary: Did you have a background in education or anything related?
Tina: Now. Well, sort of start a way sidebar, I was in human resources at my job for some years, and there I had a lot of courses in mediation, conflict resolution, behavior, that type of thing for dealing with grown ups in the human resources world, which some of that turned out to transfer a little bit, but now not as far as autism and that kind of thing. No.
Mary: Yeah. You say that, you know, human resources and dealing with problem employees and adults, and it is all related. I mean, I was a nurse manager and then I became a behavioral analyst there's a whole field of abay called OBM organizational behavior management. And it's all the same principles, whether we're talking about young kids with autism or we're talking about, you know, employees. And so I've done some podcasts on these principles. Amy Sutherland, who wrote the book What Shamu Taught You. We can link that in the show notes, but I mean everything. The four functions are all related to all of our behavior good behavior, bad behavior, whether you have autism or global delays or you're typically developing. And so it's interesting that really anybody's background can can apply, right?
Tina: Absolutely in some way.
Mary: Yeah, exactly. So and we do have permission for you to talk about Wyatt to use this first name with permission from you. We have permission from Wyatt's parents as well. And you know, I absolutely do want to, you know, tip my hat to people like you and Wyatt's parents for sharing your story because only when we all share our stories. I know you said you listen to the previous hotseat I did you're hot seat number five. You know it. It helps. It helps to say, OK, well, I read your Turn Autism Around book or I've done your courses. But you know, these kids are all different, all different ages, all different strengths and needs. So you have submitted your assessments and plans and everything like that. So I'm assuming that you do live near Wyatt and you do have him at your house for some time. Not full time, but some days. Is that correct?
Wyatt’s Therapy and Progress
Tina: That's correct. He actually has ABA therapy here at our house two days a week and three days a week at his house. And so, yes, he here anywhere for some hours, three, four days a week. And whenever he's here for any amount of time, we work some table time in. And then his parents on their side, I gave his mom your book when it came out. And so they. Actively worked to keep Wyatt engaged, you know, as much as possible throughout the day, and then he has his other therapies where he goes to a clinic for those therapies.
Mary: Yeah. So since you've started my course at 14 or 15 months of age and now it's a whole year later, he's two years and six months, is that correct?
Tina: Yes he is two and a half now, almost two years and seven months.
Mary: OK, so what kind of progress has he made through, you know, all the early intervention programs as well as by you taking my course?
Tina: Well, he just seems to be doing progressing really well and in in several areas, others have been more challenging as far as feeding self-care, that type of thing. But we are working on those. But table time, like I said initially, was a few minutes. I had a little chair that he really was barely even sitting up in And so we had a chair and had stuffed pillows around it, you know? And so I gathered the materials and I was sort of trying to work with the shoe box. I got pictures of parents and grandparents, but he was very he didn't want me to work with his hands at all. And that at that point. And so I did several times go to the Facebook group. The community and Kelsey and others were always very prompt and helpful and really were just giving me some suggestions. But also, you know, just advising, just keep working, keep going when even if it's a few minutes a day, but be patient h is so, so young and just be patient, but keep going. And that was very helpful to me, too. Yeah. Well, it's just I'm not doing anything I should be doing. It's he's young too, and we're learning together.
Mary: Yeah. And when you say he didn't want you to do anything with his hands, he was prompt resistance. He didn't want you to touch this. You to walk him through. And we see that with kids with autism. I don't know if it's a sensory thing. I don't know if in the past, you know, everybody's been trying to over prompt. And I know with our programs as one of the reasons why we do like to pair a table. We do like the early learning materials we do like to to actually not dove in right away was sign language because a lot of times if you're trying to, you know, go in and trying to manipulate their hands, even if they are going to get something, it's just too much. It's like rushing in and and you're like, so confused and not aware that we'd like to really have the child be, be calm and move their bodies as much as possible. And then always and I'm sure you and your son and daughter are very gentle. And you know, in the early intervention, professionals are gentle, too. But even if you are gentle, too much prompting will become aversive. And that's what happens with young kids that are very delayed. So instead, instead of like the child just getting their coat on, then when therapy starts, it's like, well, they got a help and that becomes aversive. That can lead to problem behaviors, prompt resistance and also tantrums and other, you know, more serious problem behaviors if you push it too hard. So I do have quite a bit in my Turn Autism Around book about self-care and how that's really important. And in terms of we're going to dove into his particular assessments, but also just to circle back to that global delay. That is a very common diagnosis of kids early on. OK, I just did a podcast interview that's going to come out a week or two before this podcast, and that is with Dr. Cheryl Tierney Avis, who is a developmental pediatrician. And we talk about the new CDC milestones in terms of surveillance. And so those questions that they were asking Wyatt's mom, does he do this? Does he do that? Does he do that? That was what the old guidelines, which are now there have been some pretty significant changes, but that is surveillance just to catch kids that aren't sitting up, that aren't drinking from an open cup, that are not looking when somebody comes in the room or whatever the the specific, well, check surveillance criteria are, we can link Dr. Cheryl Tierney podcast right here, too. And a lot of times these show notes are really good for, you know, kind of digging in a little deeper. And so I know there's many, many families out there and early intervention professionals who are struggling with kids that sound very similar to Wyatt. So again, let's just dove in to there are four steps of the term autism around approach, and the first step is assessment. And so you've done a nice job where you've completed the one page assessment and you also before we get into the one page assessment, let's just talk about the language, Sam. All in the language sample. You know, when you start my course, which was over a year ago, you know, you did a language sample. This is what what we're going to post in the show notes is a more recent language a sample language sample for March. And it's it looks like he's got several sounds and words and word approximations, several clear words, several unclear words and so on. In March of 22, at table time, in 15 minutes, he said Table clearly. He said Table Moon B ball, the donkey war, baby and owl. And you'll see a lot of one to two syllable words with kids. And so that's great that he has that many clear words, and in end, he has a handful of other words that are less clear. And then you also did a language sample while you are driving well, hopefully you aren't driving. You were recording. I was riding in a car together and just looking down here. That would be funny. Well, not funny. Don't do that at all. You're driving anyway. Riding in a car with white, and that's a good way. Like these language samples, people are like, Well, should I try to engage? I'm sure I do at the table. Should I do it outside? You know, do a couple of samples because you might notice that in the afternoons outside you get more language, or you might notice that a table time with the materials, you get more language and you get different words. And so doing a couple of these 10 or 15 minutes up to an hour. Language samples are just a great idea. So it looks like he's got a lot of words. He also said Apple meatball and bite and then some unclear words. Some of the unclear words you have written down on your language sample. Again, this is going to be in the show. That's just going to be podcast 174. So Mary Barbera dot com for research 174. If you are outside, running or exercising or in a car and you don't, you can't write it down. You can always search Mary Autism, grandparent, hotseat, five, whatever and you will find it, but it's going to be one seventy four anyway. The language samples showed some unclear words like truck and fly. And when you think about like truck and fly versus bee and me and all, you know, truck and fly have really pretty difficult blends, which is hard. You also have, on their unclear words, butterfly. And so that's a three syllable word. So we have to always look at the words for clues. I remember in my book or my course, I talk about Chino, my little former client Chino, who could say Cheeto, and he could say no, but he didn't say Chino correctly. And so sometimes it's it's looking for clues within the clear and unclear words. OK, then the that's part of the assessment, the one page assessment which you filled out, which is available in a PDF syllable format, as well as a handwritten format. And that's going to be in the show notes as well. So the biggest struggles that Wyatt is having right now? Can you tell our listeners what what you're most concerned about, just generally on the one page assessment?
Feeding Issues and Autism
Tina: Generally, would definitely be feeding. He only eats baby foods that are fed to him, and he drinks water from a cup, a straw cup. But he'll put it up to his mouth. We have gotten that to work. He'll take the cut, put it back to his mouth, the straw cup. But we still have to actually do the squeeze to get the water into its mouth. We're starting to work now with open cup, but it has the top with the little slit in it. You can tell me if that's good or not, but it seems like that helps him. He can lift it up and then he's getting to where he'll sort of turn it up to drink a little bit, but that's where we have been. He does a great variety of different baby foods, but our issues have been more with texture and variety.
Mary: OK. And so in terms of feeding, does he drink anything else like out of a bottle or
Tina: No. He's been off the bottle. He has a pacifier at nap and bedtime, but only he only drinks water since it's been such a manual process with the water. We were sort of we weren't sure about introducing juices or anything like that because we want it, to be sure. It's important that it gets enough water each day, so water right now is what he has.
Mary: And he doesn't drink any milk.
Tina: No, he we gave him yogurt. As far as his baby food for hopefully some meal, that kind of thing, but no, not not milk, since, you know, since he's been off the bottle and formula.
Mary: And how long has he been off the bottle Olin formula, was that an easy process or is up and just reset?
Tina: No, actually, he pretty much take himself off the bottle. He didn't even want it. I don't know if it was the second. I don't know if it was the formula. I don't know what it was. But he never really was that fond of it. And then, I guess maybe about six months or so ago, he just sort of almost pretty much started refusing it.
Mary: OK. So, you know, and before I continue, I do want to say, like everything I say here, everything about, you know, talking, eating anything I say is for informational purposes only, I can't actually give you real advice because I don't know why. I'd never observed him. I've never looked at his, you know, assessments, especially with beating. I want to. I want to make that announcement because, you know, he could have chewing, swallowing problems. He could have malnutrition, he could have scurvy. He could have, you know. And I know here I am talking about X, Y and Z, and I should be, you know, focusing on that. But you know, this is just a discussion to help people out there. Yes. So the episode 95 with Dr. Keith Williams is really important because he is an internationally known researcher in the field of picky eating and feeding disorders, and he was on on ninety five and he said, like scurvy and rickets is through the roof now for, you know, first time. He's seen it in decades and these kids are actually and I don't think that's the case because he's getting baby food, and that probably has like a lot of the nutrition in there. But so you we want to link that in the show notes. Has he ever progressed it like he won't eat any like Cheerios or those cracker things of babies chew on? He doesn't do any of that.
Tina: Well, in fact, just terrible recently, my daughter in law is burnt out has told me that at his feeding therapy and speech therapy, they're able to give him, they're like the little star shaped kind of I don't know if they're crackers or whatever, but they break off like the points of the star. And given that maybe he's barely in, he'll accept that a little bit as art. What Dr Williams? That was one of my favorite podcasts. I I did order his book. I was actually very fortunate. I emailed him and we were actually able to speak a couple of times. He was good enough to me and he was the person that actually worked with us to help get him to get the cup except the cup and gave the cup to his male and, you know, a bench. And so he was great. And of course, he at first it was just general information. Also, he didn't know why, but he was just coming to talk to me and walk me through a little bit of that. But like you say, it's kind of intimidating, I guess, for all of us because of choking or gagging or throwing up. You know that where I can be more of a detective and try things with speech and play, you know, not so much with feeding.
Mary: Yeah, it's really dangerous now. Is he gagging or throwing up?
Tina: No, no, we've been really lucky with that. He has had gastrointestinal examinations, some feeding evaluations, in fact, he's going to have another one in a couple of months. They haven't found any medical reasons, though, because I know how you stress ruling out medical. And so we're trying to do that. But yeah,
Mary: Yeah. So the other thing is, you know, if you might want to investigate, like, I forget what they're called, but they're little hard cookies that nine month old just suck on and and, you know, just see if he'll he'll take that or, you know, with a feeding therapist there. But there are all kinds of feeding therapies, too, and there's more like sensory, oral versus behavioral. And I would say, you know, Dr. Williams and my approach is it's really behavioral. I mean, of course, ruling out the medical issues, too. And I'm thinking his height weight is OK?
Tina: Yes, his height and weight is OK now, and his weight is a little bit under average, but it's not at a point of medical concern, and he's definitely slender.
Mary: And do any of the foods have like chunks in them, will he accept that?
Tina: I don't know that I've tried that, and that would be a good idea to try something.
Mary: The other thing, especially with kids on the spectrum, they can get very brand specific and container specific. So if you're out buying jars of baby food with the little baby on it and feeding him directly out of that, I would really investigate whether you can puree real foods during a down, smooth, smooth and then stop. You know, I mean, of course, this is all assuming he can swallow and everything. But I do have a story that I've told many places. I'm not sure where I tell it if I tell it in my current book. But you know, I evaluated a six year old who was eating corn chips and french fries in the cafeteria at school. And then his mom wanted to see me and she came in and. And he was six. And, you know, she's like, I'm losing my mind. Her husband was off fighting in Iraq or Afghanistan, and you know, I have him and I have an eight year old son and I can't even take him to the grocery store. He's not potty trained, so it's like the money for diapers and he's clearing shelves, and he didn't seem like that at school. And then I said, Well, what about food? And. And she said french fries and corn chips. And then I said, Well, what about the proteins and vegetables? And she's like all only in the baby food. And I was just like baby food, but I was trying not to be like, what a six year old who could chew and swallow eating baby food. That sounds weird. And she I said, Well, how much baby food are you buying? And she said, fifty two jars a week. So you know why it's different. He's had global delays. He's never eaten. He doesn't eat corn chips and french fries. But there may be listeners out there who do do baby food because of the nutritional facts, and they can chew and swallow. But like one step towards more normal food is to start doing your own food, taking away the processed baby food that's in certain containers, even dumping out regular applesauce regular. You know, when when Lucas did a feeding program, for instance, every time he had a meal, it was in Styrofoam cups that were not see-through so that he didn't know what was coming. So it was applesauce. Yogurt, maybe. And I know...
Tina: That's a great idea.
Mary: Yeah. So some of that you know, you may want to play around with a then you if you were pureeing your own, you could change the texture and make it one beer. OK? And then the other thing about feeding, which I would recommend for everybody. You didn't do it because he's really just taking the baby food that you feed him. But in Chapter 10 of my book and then the free book resources, which you can get, which we can link in the show notes there is a feeding form where you put down the easy foods, the medium foods and the difficult foods. And as you progress towards more chunky things, maybe you could make those. Or maybe he does have a preference, like with he doesn't like orange baby food or he doesn't like bananas or whatever, and that could go in the medium. And so instead of just OK, he's two and a half and he's just going to get smooth baby food, non orange or non banana or non fruit, you know, start to apply these techniques where it's a slow shaping to get him to eat better and eat variety Yeah. Well, it's very exciting that that Dr. Keith Williams did call you back and like, helped you a little bit, which is very nice.
Tina: He was so kind. Yes, very kind.
Mary: OK, so the feeding, I think we kind of went over some of the ideas for feeding. Also, I will link in the show notes I did a really good podcast interview with Melanie Potok recently from Lunch Bug, and she is a SLP who specializes in feeding. She has a little mini course. And she also has a lot of good graphics on Instagram about what sippy cups to buy, what not to buy. I would really try to get them off a pacifier at night and a nap. I don't know that that's a huge problem. If you was on a bottle, I definitely, you know, I have six steps to weaning. We can link in the show notes weaning from anything, even waiting for baby food. You can apply the same techniques in a behavioral way. And then finally, in terms of the feeding, you already have feeding evaluations and feeding people in place, but make sure you get behavioral feeding people into the mix. Because you'll make more progress, I think. And then also no calories in between meals, but that's not such a problem because he's fed his, you know, you feed, somebody feeds him. That's another thing is, you know, if anybody works on, you know, you could have adaptive spoons with thicker stuff like applesauce versus very thin stuff that comes off the spoon very easily. You might want to have him start to feed himself, and therefore he could suck on like cookie kind of things that are made for babies might be good as well. All right. OK. On to language ideas before before we go to language, let me just say that from the one page assessment, I know we kind of jumped in to feeding very quickly. But from the one page assessment, that's when you create your one page plan with the strengths and the needs. So before we jump into some language interventions that I might try based on why it's specific examples from the one page plan, you did say he has some strengths. Can you tell our listeners just a few of his strengths?
Tina: Yes. Well, he sleeps well, sleeps through the night, knocking on wood, and then we take a nap. He loves. He imitates and he loves to imitate. He's able to label items and books he loves to do that. I've been trying so hard not to like, go further than I should with him, but he loves letters, numbers, shapes. He just loves that he loves to identify them. And so we have sort of in a recently, I don't know if it's a podcast, but something we said, if they really like it, then, you know, move forward with it. And so we have some. But he and he usually responds to his name and he'll clap, touch body parts, stomp, wave his arms and all of that usually. But you can just say, and you clap and he'll clap. I don't have to show him a clap and say he'll do those things just verbally with us, verbally asking. So also, he's starting to do some matching and so exciting every time I see him scanning, you know, and picking out, picking something out. It's just the things about your course that have been so helpful to me to know how important of a skill that is. And I tell you, just maybe three or four months ago, it was still, you know, just sort of a few minutes. And then, like you had said at one point, it almost seems like it starts clicking and it starts moving along quicker. And then I'm like, Oh gosh, I do need the early learner course, and I better get on the quick win for so many months if he really wasn't ready for it yet. So. And he enjoys sitting at the table, which is great too.
Mary: Yeah, which is huge. I mean, I think sleeps well and enjoys being at the table and imitates and matches. I mean, that's those are all amazing skills, any. And he has some language and he's going to have. He has more language and he had a month or two ago and he has more language coming. And so all of that, I think, is going to help. And yeah, so those are all listed on the strengths column and then the needs are the baby food, the feeding issues. One other thing I wanted to say and a couple of other ideas about feeding is making sure that his zinc level is OK. I did a podcast with Missy Olive where we talked about zinc, and we also have. I also did a video blog on the zinc to copper ratio being messed up. And then there's other blood draws that you can do zinc and copper, and you can also look at like magnesium and other things. And also the juice question you said he just drinks water, you didn't know about juice. In the Keith Williams episode, he actually says that for some kids, he does like to introduce juice, and that has a lot of vitamin C in it. And I think he's getting that in the baby food. But and those little juice cups are pretty well, they're easy. And then there also have a very thin straw with a squeezy thing. He may be able to, yeah, you know, he may be able to handle that juice. And if he likes sweet things, it may become very reinforcing to hold it and to suck all the same time. Now, I wouldn't let him run around with anything related to eating, but I personally, I know when Lucas did a feeding program, he only ever drank water and they did introduce juice. It's also good for putting like medications and supplements in it. And also, oh yeah. So like smoothies, even if you can skip smoothies and you can mix all kinds of vegetables and fruits, and you know, if he did need zinc or magnesium, you could put that in. So those all might be something to consider. OK, so also in the needs column besides the eating, which is, you know, I think really would be my top priority, but talking and then also self-care and then at at the bottom part, your plan you have, you know, basically just continue what you're doing. And it's great that you moved from the toddler course to the verbal behavior bundle. You added that recently, it's all related and you might think, Well, do I really need? Yes, yes. Actually, if you want to keep learning, it's just like learning the guitar. You're not going to be great at the guitar. If you stop after the first series of lessons, it's the same thing for anything we're learning. And these are complex questions and the fact that you have time, you have the motivation. I mean, I can't think of somebody with more motivation than you. And once you start seeing progress, which you're seeing, it becomes easier and easier to, you know what? I'm going to make a plan. I'm going to do those five hours, these the next 20 minute lesson, I'm going to make a plan to start that tomorrow. I'm going to have a plan that one Wyatt comes over on Thursday. We're going to try a juice box. We're going to try, you know, X, Y and Z because hey, if you can see it right before your eyes, it becomes incredibly motivating to keep going.
Tina: Yeah, absolutely. It really does.
Language Skills, Self-Care, and Autism
Mary: Yeah. OK, so before we move on to you and then self-care is also a big one, so we're going to talk about language and self-care. Do you have any before we move on to language and self-care ideas, do you have any questions about feeding?
Tina: Well, I've just I've made a lot of notes and those are just a lot of great suggestions and we do from listening to you. I I have taken it out of the baby food, out of the jars, and you have the segmented dishes that we use. But I like that even more about the Styrofoam, where you really can't even see, you know, because he's very attuned to, Oh, what's that color? I'm not used to that color, baby food, that kind of thing. You know, he notices things like that. So that'll be great.
Mary: Yeah, good. OK. So for language ideas and these I took a little bit of time last night went through all your assessments and language samples. So these are related to what you wrote down, but I'm sure that others listening can also benefit. So I do explain somewhere in the course for sure, and I think it may be my first book not sure about my second book, but I talk about these ideas so much that I don't know exactly where they're at, but the number one and number two word lists. Are you familiar with that concept?
Tina: Do you mean list that I would make?
Mary: List that you would make so this can be done on a piece of paper or are we just going to use my whiteboard here? So Wyatt has some clear words and some unclear words. So basically, number one words are clear and number two words are unclear. OK. And this would be a general list that you would add to. And if you have a child with a lot of words, now why it is two and a half, so you should have a lot of words. But he's also a fairly new talker, so I wouldn't get too crazy about articulation at the moment. But what you don't want to happen is you don't want number one words to fall apart because everybody's kind of reinforcing different variations. So number one, words can sometimes be clear, sometimes not be clear. So Apple is clear now. What does that mean? Clear? You know what I mean? Like his mom could think Appa is clear and you could think Apple is clear. And you know, and for a two year old, two and a half year old, even if they didn't just start talking. There is some subjectivity to it. I would say that if you can, like, have somebody else presented the cards and you can turn away, you don't know what the card show and he's saying Apple enough for you or your husband or your daughter to go like, Yeah, that was Apple. That's clear enough. But Apple's a good one to write down first because it's it really is great if this list is in alphabetical order. So that way I know what a clear word is and what clear words Wyatt has or the child has. So Apple bite ball bite bee, when you were asking about. Number, letters, and colors. Actually, I wrote down is I would get ABC and one to three puzzles because he already has B. I think he has some other letter sounds. Letter names? OK, syllable. So letters and numbers are one syllable so that they have motivation. Yes, I would do it. I had a little client who needed a lot of reinforcement, had extreme feeding programs. Problems only drank out of a bottle and ate gluten free crackers. Morning, noon and night. That's it. Just drank almond milk. And we actually went to Keith Williams for an evaluation and treatment, and we needed a bite for bite reinforcement. And that was ABC puzzles. So I think that's fine. That's on my list. But anyway, just getting back to our number one number two word. So then unclear would be, let's say, cat dog fly and maybe oncat, we would just say, he says ca instead of cat, like he doesn't put the T on, dog he might say, og you know, I'm just saying whatever, fly, he might say fy. And so you would put what he says.
Mary: And then you know, you'd work with an SLP speech language pathologists, if needed or you say, you know, he doesn't say cat with a T but he says pot or he says something else that or with Chino, he says Cheeto like, that's an important word, you know, because it's so related to his name. Yes. And even with your ABC puzzles, if he could say why, then he'd have the first part of his name. Right? So and you know, you might think, well, cat, at that is important because in it, so you get why it, you know, and then if you can get it and you can get why you have his mate. So looking for clues at the unclear. But the real important thing is so that everybody knows his number one list in alphabetical order, so I can scan it quickly and I can say he has mama. He doesn't have mommy, he has ball, he has B, but he doesn't have bumblebee or whatever. And then that excel sheet could be updated every week or every month, and that sheet could go on his binder. It could go on your refrigerator, on mom's refrigerator, at school. And so that we're all on the same team, we're on Team Wyatt to get his language up. So that is a Number one/Number two word list. Yes. Awesome. OK. So we want to keep the bar high for those number one words, and we want to make sure they are practiced throughout the day as much as possible, not just off the table. OK. We want to have pictures of all those words. So for that, we want to have double pictures of all those words for a match. We want to have lots of pictures. You want to have a set of pictures at your house, set of pictures at Mom's House unless you're traveling with materials, which is fine too. And then there's an articulation podcast and blog with Dr. Joanne Gerenser, so we can link with some of these ideas. Additional ideas. When you say he's drinking out of a cup with a straw and he's starting to drink out of an open cup, does he ever drink out of like a spill proof sippy cup at other times during the day on his own? Does he drink from anything on his own?
Tina: No. No. Doesn't drink from any.
Mary: What about a water bottle with a sports cap? Have you tried that? Like with a nozzle.
Tina: No not a nozzle nothing like that.
Mary: I would try that. I wouldn't try a huge bottle. I would try like a baby bottle, like a like a little kitty with a sports thing because it's water. And that's good to travel with, but no spill proof sippy cups because they're really bad for articulation and for sucking. So Joanne Gerenser, when I read her name that made me think of her, she's she's key for that and then just continue with your early learning materials daily. I would add song time if you don't have that going. A lot of these fill ins can be songs, can go with imitation, can go with prompt resistance, make it fun. It'll also increase imitation, which you said he likes to do. There's an imitation blog you can watch. We can link that and then add I would add ABC and one to three puzzles. OK, any questions about those language ideas?
Tina: Well, it just seems like the vowels are great, and he has a few consonants B, M, W. But I think a lot of the word issues come with not having very many consonants, and I never had thought about it before. But like if I do a t, I've got to have my tongue at the top. I mean, there's some movements, you know? And so I never thought about having to break that down.
Mary: Yeah look at blends and look at whether the tea is at the beginning of the word or the end of the word or in the middle of the word and your tongue movements. And he obviously has oral motor movement issues with feeding. We also did a police interview with an SLP BCBA Mags Kirk on talk tools might be something to look into, and we can link that as well. Yeah, OK. And then finally, the self-care issues are, you know, you filled out the self-care checklist. We can put that in the show notes we'd want to break down in the bonus video boards because you are a member of our verbal behavior bundle, there is a hand-washing bonus. VIDEO I think that hand-washing bonus video is actually free for everybody to we can link down. The show notes there is an additional bonus video in the Verbal Behavior Bundle. All about those consonants, vowels and vowels do come, so you can look at that. So you have the self-care checklist by Dr. Mark Sunberg. That's excellent. We want to always prompt from behind. So if you're trying to have him feed or feed himself or bring a cup to his mouth, you want to be behind him at all possible and hand-washing, OK? You want to be behind him brushing teeth. You want to be behind him. You always want to be gentle, have strong reinforcement after those kind of things. Small water bottles with spouts, juice boxes, the honey bear cup you can squeeze and the juice or water will come up. And then even for pants up and down over a diaper, you want to be behind him again gently. Can use video modeling of, you know, different things. Maybe that will help having you said Wyatts has some cousins, you know, maybe they could do something on video like brush their teeth instead of just that brush. So you could do like toothbrush, toothpaste and then one two three four five. So you're counting while they're doing each part, all kinds of things you can Google on YouTube for toothbrushing, two year old brushing teeth, with song just trying to make it fun, make it appealing, and those are just some of my ideas. I mean, just keep going with the courses, keep spreading the word. So we're going to wrap up any last idea are questions about those ideas for creating language or self-care?
Tina: Well, I guess on the language, I'm thinking that I'll learn this in the early learning, but he does like to imitate. And so sometimes it's almost like we know he knows the word, but he doesn't say it until we say it first. So I guess the strategy to have that become more proactive on his part instead of needing to be prompted in the beginning.
Mary: Yeah. And in the early learner course, which is the first part of the VB bundle, we talk about transfer trials and we talk about oral is teaching. And that's the other key is to get all of these words as pictures that way. It's not like I can hold up a ball and if he doesn't say ball, I can say ball or buh and see what he says and then I can try it again. Oh, right, right. What is it? You know, and so that's a transfer. Oh, OK. He is like, you do anechoic prompt and then you say, OK, that's right. Do it again. Say it again so everything can be taught. And that's the way you fade your prompts with transfer trials. OK. Yeah. So OK, let's move on to just in general, your role as a grandparent like you've been able to, you know, become the co-captain of the ship. Like, it's not your child, but it's your grandchild and you've been able to work with the family to, you know, really help Wyatt. But I do see some grandparents in our community and we have several an are in more frustrating situation, because they can't get through to the professionals or they can't get through to the child's parents to not use punishment or to do this or to, you know, like are you? Do you have any advice for parents or grandparents who are out there who who are not in as good of a situation in terms of collaboration?
Collaboration with “Co-Captains” of the Ship
Tina: Well, just to try as much as possible to collaborate, I think, because of course, I always have to be cognizant and realize that they are the parents. And there's nobody that wants Wyatt to succeed any more than his mom and dad. And so, for example, they really weren't. I wasn't that familiar with ABA, and they weren't at all. And maybe if they were it was what I sort of called the old ABA, but they had a trust in me because I felt so strongly about your program and about ABA therapy in general. She gave it a try, you know? And so conversely, you know, she had a really good relationship with the therapist at the clinic. And so that let me know too well that that's what I need to know. She has a good feeling about it, a good rapport. And so we sort of have common paths and then we have our paths we're forging, too, but just try to have a lot of communication and try to work on collaboration as much as you can while realizing I am the grandparent, I'm not the parent. And to just work as hard as I can, continue your courses and the table time, etc. And they've incorporated some of that into their lives, too.
Mary: That's great. So before I let you go, I think this is really great episode and will be valuable for a lot of people for years to come. But before I let you go, I like to really not just help the kids, but help the parents and the grandparents and the professionals listening to be less stressed and lead happier lives. So do you have any wisdom for us, any self-care tips or stress management tools that you use that you would recommend?
Tina: Just a couple come to mind. One being that my husband and I, we both love to travel. And so a couple of one or two times a year, we'll take what we call a big trip. But throughout the year, we'll also have some weekend trips. My daughter and my granddaughters live in Atlanta, so we might go to Atlanta also this year, my son and daughter in law's 10th anniversary. And so they were able to get away for almost a week. And we were. We watched Wyatt. It was great. And so I could just see from their pictures how relaxed and how happy they looked. And so travel, I think is is a good refresher and a good getaway. And then secondly, what I've learned, I guess I always knew it that was reinforced in books that I've read is when I start, just start getting weighing on me. I can think about many things, many blessings and many things to be thankful for. And a lot of it is things that I see and do that maybe a year ago, I would have watched some of the videos of the kids at table time, and I would think if Wyatt could just do any of that, you know, it would be so wonderful. And now to see that, you know, I think just the attitude of gratitude and thankfulness of our blessings now has helped me a lot.
Mary: Well, I think those are excellent. And with that, you are a blessing to our community, your blessing to Wyatt and to his parents, and for helping us spread the word that you know, to put one foot in front of the other doesn't matter what the strengths and needs are. We can make progress. We can collaborate, communicate and really make great strides. So thank you so much for your time.
Tina: Thank you. Dr. Mary, we appreciate you so much. You're definitely part of our family, friends, professional community, and you have given me so many great resources, your course, of course. But also Dr. Williams, Dr. Sunberg, Temple Grandin and just I could go on and on with the people that you've introduced me to that have helped changed our lives.
Mary: Well, thank you. Alright have a good one. And I'll catch you all next week.
Mary: If you're a parent or an autism professional and enjoy listening to this podcast. You have to come check out my online course and community where we take all of this material and we apply it. You'll learn life changing strategies to get your child or clients to reach their fullest potential. Join me for a free online workshop at MaryBarbera.com/Workshop, where you can learn how to avoid common mistakes. You can see videos of me working with kids with them without autism. And you can learn more about joining my online course and community at a very special discount. Once again, go to MaryBarbera.com/Workshop for all the details. I hope to see you there.
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