Janine came with my other new therapist named Jennifer. Jennifer seems really nice and I'm convinced that I've been blessed with some truly amazing people who are going to do great things with Raquel.
Just a few minutes into it - I don't think they even had all of their paperwork out yet - a tantrum started. Again, nothing I could do would redirect her, except for, of course, THE ROCKING CHAIR. I rocked her, she fell asleep, and then I had Janine looking at me from across the room the same way Elizabeth used to, giving me the "you-totally-just-reinforced-the-behavior" look. Janine said she would give her ten minutes to sleep, only ten minutes, and then it was time to work.
When I woke her up, she started the tantrum thing again but this time Janine told me to let it go and see how long it takes for her to calm down. She also noted certain things, such as Raquel wanting 100% of my attention at all times. If I was answering questions and not giving her my undivided attention, she got louder. Janine asked me to not acknowledge her by picking her up or making eye contact when she was carrying on. At one point, she asked me to leave the room entirely. I'm not able to do this when I'm home alone with her because of her self-injuring behaviors, but they followed her around with the pillows during this time. They asked me to come back in the room when she quieted down and to make a big celebration out of it. This is teaching her that I will only pick her up and give her the attention she is requesting when she is acting more appropriately. This went on for about 30 minutes.
Janine wants me to create an area at the end of our hallway to confine her to when she is throwing a fit, a place that is padded where she can't hurt herself and I can leave her there to cry it out and go in the other room. I'll need to work with Mike on creating this and completely agree that it needs to happen.
She also calmed down when we played the music. They did the majority of their session with music in the background but, again, Raquel needs to learn how to request it being turned on or off in an appropriate manner instead of just having a fit.
Janine implemented the PECS program today. She overlapped with Mary for speech therapy yesterday and both are in agreement as to the direction we are going. These are pictures she took, laminated, and affixed to our fridge door. They represent: cereal, applesauce, milk, juice, and yogurt, and the picture of Raquel in the high chair means "eat" in general if she wants something else.
We also have these pictures on our back door:
The stroller means she wants to go for a walk, our dog Annie is for indicating she wants to play in the backyard, and my car means going for a ride. We will be adding a few others over the next couple of days. How does this work? We were doing it today with the juice. I knew she was thirsty so Janine handed her the picture of the juice. I had her juice cup. I said, "Juice?" and they had Raquel physically hand me the picture and I then gave her the cup while praising her and repeating, "Juice!" We did this several times. Janine is also putting together a PECS book which will contain pictures of some of her favorite toys and things.
Why are we doing all of this, especially if she can already say "eat", "milk", etc? Because Raquel doesn't have consistant communication and is so easily aggitated. Janine noted today that Raquel can go from zero to one hundred in just a matter of seconds. That doesn't give me very much time to figure out what she wants. If she tells me "eat" and I grab a yogurt and she actually wanted some juice instead, there's a problem. By her being able to hand me a picture of what she wants is supposed to eliminate the behaviors, and that is truly the goal right now.
It's a lot to take in and is extremely overwhelming. Both Janine & Jennifer left today very pleased with how the session went. I was shocked. Janine calls Raquel her "rock star" and Jennifer said she is so excited to be a part of this. I'm curious to see what tomorrow brings.
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