Yep, that's a lotta sticky notes. We usually start with something physical to get us up and moving so I decided to do the deep pressure to Sam's legs and feet and then jump on the little trampoline. We are still working on getting Sam to jump, he will jump into a pool but not really just jump on a floor. Then we move over to the computer, one of Sam's favorite things. We start by working on the 1000 most commonly used words in the English language, inputting about 15 new per week and reviewing the old. To help keep Sam's attention I put pictures of his family in between and we talk about the picture...always working on that speech.
Also on this same PowerPoint presentation are his dot cards to help him identify amounts at a glance and his addition flashcards. We are currently working on inputting so I show him the dot card, tell him the amount and move to the next one. I love using PowerPoint because I never have to worry about misplacing my cards and I can make changes as needed. We tend to go through new words twice and the review words once. But this process is repeated a second time later in the day. After this we run over to the punching bag, roll our big spongy dice, read the number and punch the bag that many times.
Then it is back to the computer to work on some reading. One of our fellow NACD families had scanned in some of the stories from a Level 3 reader and added some great pictures so we read those onscreen. Sam is still not comfortable reading the Level 3 readers from the books, I think the amount of text on a page and the size of the text makes it difficult for him to track and he becomes tired and frustrated. But when the text is onscreen you can enlarge it, show one line at a time and highlight the words as you go. Sometimes with Sam it's not his inability to do something it's figuring out how to make it work for him. After reading we usually move on to Zoodles.com or Webber HearBuilder Following Directions. He loves both of these because he is playing games and doesn't seem to realize the important areas we are working on. After 10 to 15 minutes it is time to get some exercise and play WII tennis, great for hand/eye coordination. I still need to assist Sam hand over hand but each time we play he begins to participate more and more. We are also working on bowling and baseball.
Then it is on to some speech activities. I place sticky notes on 4 items in one room, Sam has to locate them and then we talk about what the item is, who's it is, where it is and what it is used for. If Sam has difficulty answering we use our scripting again to help him along. We move on to some trigeminal stimulation and facial stimulation to wake up those muscles in the face. Then sitting in front of a mirror we practice moving both the left and right side of our mouth with a little, OOOO & EEEEE work. Because of Sam's brain injury the right side of his body is a little weaker than the left
side so we work on toning up both sides. We then move on to some oral motor exercises, he watches me move my tongue up behind my front teeth, then down behind my lower front teeth, putting my tongue into my cheeks, puckering, smiling and a few others and he trys those activities himself. We then work on our functional words and phrases with a lot of emphasis on proper articulation. This can get boring for Sam so sometimes I add my own funny faces to the oral motor part or I ask him to repeat the words into the tape recorder or to Dad on the phone or to his dog Buddy. Buddy will normally reward him with a big old wet kiss. We usually break into something physical again like a WII game, trampoline, punching bag or practicing connecting Buddy's leash and taking him for a walk around the circle.
We then return for a math computer game, one of my current favorites is Reader Rabbit Preschool through 1st Grade. Math is not one of Sam's favorite areas so we are still working on the basics. This computer game has a lot of fun activities that if I tried with Sam on paper or with manipulative's he would fight me but he will work on the different areas in this game. Again this was another area that we had to figure out what was going to work with Sam. Please don't get the idea that everyday is a smooth running operation because it's not but each day we get a little bit better at figuring out how to work together and still make it kinda fun. We also have a math game called Stomp that requires Sam to step or stomp on the button which causes the numbers to fly off and then he has to listen and replace the numbers in the right order. We have not moved to the higher functions of that game yet.
We introduce 20 new receptive language cards to Sam a week. I love printing off the free flash cards from the ESL (English as a second language) websites. Due to Sam's hearing issues he has not always picked up on the words people use around him. He needs to have new words introduced to him with good articulation and a visual or picture. When I went to a deaf and hard of hearing conference they emphasized the need to introduce common items found in a child's everyday environment in a way that they can understand. For some children it is through sign, others may need to read the word and for Sam the picture and written word seems to be the best approach. We are basically working to expand his understanding of his environment and to expand his speech. Sam understands what a table is but now we are working on coffee table, corner table, kitchen table, night stand...more advanced receptive language. Just think about the speech you use everyday, couch, sofa, love seat, chaise, davenport...all talking about the same thing but Sam needs to be introduced to each of them and realize they are different ways of talking about the same thing.
Communication and language
Reasoning (correlates high, .8 to .9 with working memory)