Connect with Success Podcast - Episode 2, Launch Date: March 31, 2021
With Dr. Rich Smith and Dr. Lynette Scotese-Wojtila
Welcome to Connect with Success with Dr. Lynette Scotese-Wojtila where we help connect you with knowledge. Our mission is to lead you to a new and exciting way of understanding, responding to and helping all those with autism. We hope to expand your thinking about how to best serve these amazing people and how to support you in your daily struggles and celebrations.
Podcast Text (parts may edited)
Dr. Richard Smith
Welcome everyone to episode two of our Connect with SUCCESS podcast built around The S.U.C.C.E.S.S. Approachsm, the person who coined it, Dr Lynette Scotese-Wojtila and the people who use it and benefit from it every day. In today's episode Dr Lynette is going to discuss one of the most basic components of helping a child or adult with autism. She's going to give it a name that you may or may not have heard before in the field of autism. My name is Dr. Richard Smith and I'll be facilitating our discussion about this basic idea that we all need to know when it comes to autism. So Lynette, what's our term for this episode?
Dr Lynette Scotese-Wojtila
Today's term is readiness. And readiness, what I want everyone to know and understand, is observable. So I like to define it as an observable state of the human condition wherein a child or an adult is actually displaying preparedness, adequate preparedness, to meet the demands of what's going on around them. And it's important to know that it’s observable, that we're actually going to see readiness, because in so understanding that we can see it, we're going to know to look for it. So parents and teachers can actually assess if a child is ready. And it's sort of like using a mental checklist. And if the child meets the criterion and this little checklist, then you kind of have the green light, as a teacher, or as a mommy or daddy, to go ahead and approach the child and maybe engage them in something you want them to do, or learn, or attend to.
Dr. Richard Smith
So this really is more about observation, like I remember as a kid being in school and the teacher would say, “123, all eyes on me.” It's not about you being ready to receive. It's about us observing the fact that they're ready to receive.
Dr Lynette Scotese-Wojtila
Exactly. And that little phrase “123 Eyes on me” that teacher, what she was doing, which was eliciting your readiness, she was influencing you to shift your attention to what you might have been doing otherwise. She was actually eliciting readiness. But if she assessed for your readiness first as she scanned around the classroom, everyone was already looking at her, she probably wouldn't have to prompt that, so she would observe that your eyes were on her, so the little mental checklist we talked about, she had in part in her drop down box of things to check off. And that was where the child's eyes are.
If we try that little technique with a child or an adult with autism -- 123 Eyes on me -- it may not elicit their eye games, And there's a many many reasons why and all those reasons are understandable and part of how they process, or don't. But it's not just their eyes, there are other clues about them. So another part of the checklist that's really important for parents and family members and staff, is where the body is in space:
What is the body doing?
What direction is the body facing?
Is the child frontal to you?
Is the adult sideways to you?
Is the adult’s back to you?
And then the other little clue or thing you want to think about is:
What are they doing with their voice?
Are they vocalizing?
Are they talking?
Are they actually verbalizing/speaking?
Are they sort of having a weird sort of groaning voice (you might call it weird or it might sound strange to you)?
What is happening in their voice right there, what are they, what are they communicating?
“What are they experiencing?” is what you're trying to discern by watching their eyes, assessing their body position and listening to their voice. So that's sort of the mental checklist at least that occupational therapists and many other professionals will be trained to use or to assess, so we know if a child is ready for us to approach them or engage them.
I think the hard part though is that most parents, for sure, and many professionals don't know that. They don't know how to assess. It is unfamiliar to them. They don't know that readiness is a precursor to focusing. And so they miss readiness, or they misinterpret readiness, and that is not helpful to the person with autism.
Dr. Richard Smith
So I want to kick off the message today with a little story that I had just in observing readiness in my own profession. So, when we first met, we met with my daughter Madison, who we were trying to work on getting a diagnosis for autism. And then we did some pretty decent training, and some collaboration in terms of parent and therapist. Just getting Maddie ready to learn and in her own headspace, and we went through a lot there, in collaboration, and I really did feel that that prepared me as a professional.
So I wanted to share this little story of readiness that I had as a teacher so I'm coming out of my office one day at school, and coming down to the office for something, and I noticed that there was a student who was being disciplined in the principal's office, but he was really just shut, he had shut down, he wasn't listening to anything that anyone was having to say to him, he just wasn't. They couldn't get the information out of him. He wasn't offering the information up. He just kind of closed down for whatever reason, he was not prepared to listen to what they had to say. So I asked the administration if I could, you know, remove the student for a second. We walked down to the gym, and he said to me, all I want to do is run away. And I said, well that's fine, but we know we can't run away at this moment so why don't we just do some laps so he started doing some laps around the gym, and I would ask him some questions while he was running. And then he said I want to shoot hoops so I said alright.
So, I gave him a basketball. He started shooting hoops and after a while he started running around again, and eventually he sat next to me and said you know, I'm just so frustrated because I don't think anyone listens. And this is what happens today, and I just thought, Wow, this was amazing. I didn't do anything out of the ordinary except see that he wasn't ready to listen and offer him the opportunity to kind of run out some of that frustration. And that's, you know, I remember as a kid being you know, why don't just run out, you know, get some of that nervous energy out and maybe you're gonna be ready to talk. This was kind of the early onset of absorbing readiness, is that would you think?
Dr Lynette Scotese-Wojtila
Yes, I do think so, and your story is so helpful, Rich because it reminds us that readiness is something we all have, it's a dynamic fluctuating state. So the most attentive and highly observant person sitting at the opera, you know, deep into the performance, if they have a full bladder at that point, and there's no way they're going to make it till the end of the opera to relieve themselves, they're not going to be able to maintain a good state of readiness to complete the task of listening. They're going to have to take care of their body. So it's a fluctuating dynamic state now once they relieve themselves,.this is a very average every day happens-to-everyone-kind-of-scenario, they come back and they're ready again, it's that primitive, it's that common. It's that core to all of us, but for children with autism, the differences, what makes them unready isn't always something obvious like a full bladder. It's how they're wired; it could be many, many things that we'll get into in future podcasts that rob these kids in having the readiness to attend. And I want to point out that you know, readiness.
The readiness stage, for sure, is very different from skill. So if I'm going to tell a seven year old with autism that she needs to get her shoes on and tie her laces and get into the car, but as a mommy, I choose to tell her that when she is watching one of her favorite shows. She's not going to perform that skill. She can, she can perform the skill, she can put her shoes on and tie the laces and walk to the car, but she is literally unready at that point. And so what sometimes because like we said in the first episode, we're focused on product versus process. Mom might get very frustrated or babysitter or grandma or nanny might get very frustrated that she is not tying her shoes -- I know you can do it. Come on, do it. Well, it's not a debate if she has the skill, but she's not ready.
And so, instead of coming down on the fact that she didn't do it. She didn't produce it, we have to step back and determine where she was at in the process. Well she has not even made sense of the words. “Put your shoes on,” because her mind is on the show, and why that probably sounds very easy to see to the listeners out there as they listen to these little scenarios we're painting here, it's very hard to remember in the moment because of what you're rushing out the door for is to drive your kid to school or to get your toddler to the doctor's appointment, who's sick with a fever and the older child who's seven with autism isn't putting on her shoes. You don't really think necessarily gee, maybe she's paying attention to the show. And then, worse yet what you might do if you do figure that out is, click the show off. Right. And then that unleashes a whole other set of circumstances that will probably, depending on the child, further delay you.
So, you know, we really want to understand our child's readiness, we want to watch their eyes, listen to what they're saying. Watch their body. And after we do this for a while, at least in occupational therapy and people skilled in The SUCCESS Approach way of doing things, they come to sort of have an MO like a modus operandi, That they, they understand how the child operates. And so, they might determine that this little seven year old needs a three minute warning. You know in three minutes we're going to turn off your show and get your shoes on. Well, that's just like the teacher you had that said 123 Eyes on me.. Only it was a three minute difference. That three second difference versus three minute. Do you see the difference?
Dr. Richard Smith
Because they might not be ready to receive that message at the time. They're so entranced in what they're doing at that moment...and they're not really fixated on the next steps because they're not hearing it. They're not ready to receive it. That's right.
Dr. Richard Smith
Help them shift. It really is attention shifting -- it is the precursor to readiness. You have to be able to shift attention, and a lot of our kids and adults with autism have some core problems with attention and attention shifting, or shifting or sustaining attention. So we really want to treat that, and understand that in occupational therapy and The Success Approach way of doing things. And there's a whole arsenal of opportunities and methods that will help us to know where a child that with readiness and how to move them to a state of readiness. So your teacher knew 123 Look at me was going to work, but she probably wasn't treating children with autism at the time.
Dr. Richard Smith
So we've talked about that state of readiness and observing that a student or a child is ready for. What does it look like, how can we assess that?
Dr. Lynette Scotese-Wojtila:
Well by looking at their eyes and watching their body and listening to their voice, you can see where their eyes are on the material that you might be wanting them to do. So when your seven year old doesn't respond to “get your shoes on” because you notice her eyes are on the TV, you can bring the shoes to her. You can bring them to her, to move them into her line of vision, and let her know, “Soon it's time for shoes” or “In two minutes it’s time for shoes” so that increases the chances that her eyes are on the right thing that you want her to eventually make contact with, or make use of.
So we would say at that moment that she was focused, and in that case we brought it to her, but in your example of “123 Look at me”, the teacher just by a cue got your eyes to look at her face and so your teacher was assessing her your eyes as a whole, all 20 of you 25 of you. But we also can tell from the body position. So when a child is ready, they are usually frontal to you, they're facing you, or they're able to turn to you or about to turn to you. Look at their shoulders, the direction of where their shoulders are, and where their face is and their eyes are headed.
And then the sound, you know, if they're busy, if they're scripting. A lot of our young adults, and even older adults or children, script, so if they're in the middle of a script, which is sort of repeating something that's not in the present, you know, script from a movie or a cartoon or a song or something. If they're using their voice to rehearse it to say it out loud, they're probably not attending to -- or focusing on you. And so, that's not an example of high readiness state. A quiet child, or a child who is not doing sounds and being more still with their voice, or quiet with their voice, is a child who's more ready to hear something coming into their ears. So those are what it looks like -- using their eyes, facing the subject or the materials or the family member or adult with their body and having more of a quiet voice than not.
Dr. Richard Smith
And so why is it then so important that we see these signs, I mean, it can lead to a lot of frustration on the point of teachers and parents to butt heads, if they're not ready. Why is it so important for those parents and teachers to understand that readiness is an observation?
Dr. Lynette Scotese-Wojtila:
Well I think there's two reasons why it's so important. One is the child is not able to process unless they're ready to receive. Very simple, they're not able to process unless they're ready to receive. So most of the time we're engaging a child to help them process, learn or do something, right? So that's critical, they must be able to process it so they can receive the information. But the second reason is because we want to make children with autism more aware of exactly what they're supposed to pay attention to, we want to bring what is salient to their consciousness so they can free up all their energies to focus on that, because they have to by nature, many of them attend to many many different things that are not salient. So we want to present our information when they're ready so that what we're presenting is salient, it does take up their attention, it does take up their eyes and what they're looking at it does occupy their ears on what they're hearing, then information will go in.
If we don't, this is why it's important for us as adults to do it. We are not only wasting our time, so to speak, nothing with a child is a waste, right, but we're not as productive. We're not as... we would say ...we're not doing what we're supposed to do, kind of spinning our wheels if you will, if we don't wait for good readiness, and that makes us feel like I told him five times. Time's up. All right, I gave it to her six different ways. When is she going to take this bite of food? You know. Well, she's not going to if she's not ready to take it in if it’s there. So I think it minimizes frustration on the person with autism, that's for sure. And it also frees up the adult to be a little more potent with their time and energy.
Dr. Richard Smith
A little more deliberate too, and the way that they're approaching, to make sure, as you said, not that we're not spinning our wheels with our children repeating things that they're not ready to hear over and over again. So you know, we're looking for different ways to make sure that our children are ready; and sometimes they need that little physical action to prepare themselves so that we can see that they're ready. You know, we've been through three or four trampolines, at least, in our household. And I'd say you know, maybe we need a couple of jumps before we're ready to move on to the next thing. Or you need to get that excess energy out, so that we can be ready to proceed to the next thing.
What are some other practical tips that you can offer our listeners to help with observing readiness, if they see that the student that their child's not ready?
Dr. Lynette Scotese-Wojtila:
Good, great question. Well you've discovered in your family, what you said like little activities sometimes physical activity, jumping on a trampoline, doing a somersault, doing a jumping jack, spinning around three times. Those are things that the average person thinks of because the average person is not trained in the area of occupational therapy, which is my background. And so I'm going to first say that it's best to work with an occupational therapist who should know and understand your child and his or her readiness state, and what influences that. And in that discovery, they may know that they are “seekers”, you know they need certain information through their senses but they're seeking sensory input. In your case, the example you used, Rich, you might have children who seek vestibular or balance stimulation. And so they channel their energy to seek that so that kind of fills their cup. And then, wow, great, ready to go. It's kind of like a cup of coffee for us, it like fills our cup, and then we can go do things. So that caffeine, that coffee, brings us to readiness, just like the trampoline can bring your child to readiness.
But some children don't need to be increasing their, their sensory input, some nee to be quelled or diminished. So sometimes, things like headphones an OT will prescribe, or a speech therapist might prescribe, to dampen the sound, or cocooning and a deep blanket, you know a lot of occupational therapists do a lot of “dampening” that we're going to talk about as a strategy, and why we use it in future podcasts about sensory systems. But those are some of the tips of the trade as governed by occupational therapy to help that child's readiness state be optimal so learning can happen.
Dr. Richard Smith
Okay so, how hard is it to recognize readiness then, in terms of knowing when our child is ready to receive that message?
Dr. Lynette Scotese-Wojtila:
Well, for a skilled interventionist or a parent that's worked with one. It's, it's not so hard, you kind of get used to looking at the eye gaze, listening for the voice, making sure that the body is frontal, but again, you know, it's it's that intentionality, Rich, it's that extra layer, that extra time that willingness, as the adults as the mommy or the auntie or the babysitter, you know, to stop, look and listen before you expect.
Again, if it's all about process and not product, you have to support the process, you have to step the child up. So the process can be gone through step by step, instead of just expecting the child to do it. So I would say that it's easy to recognize. Readiness is very easy to recognize, but the work of assessing it can be challenging if you're not used to listening and looking at that child in that way.
Dr. Richard Smith
And so it goes back to this transdisciplinary approach, you know, knowing your therapist and having that connection with them, and how that connection is formed with your whole community as your family, to meet the needs of that child.
Dr. Lynette Scotese-Wojtila:
Absolutely because that transdisciplinary team is going to have different observations about readiness. So this teacher, your general education teacher, or your special education teacher, or your intervention specialist, they might have your child in an environment where there's a small group. And so readiness might be different in that environment than it is at home with Nana, eating dinner. So there's different influences on readiness because there's different information coming into the nervous system, that the child has to tune out in order to be more ready, so you do want that transition to plenary understanding of readiness, what influences it and then what does a child need that anybody can use to really get them ready?
Dr. Richard Smith
That'd be a great, a future episode, just talking about in terms of classroom readiness. And just looking at that because there are lots of different tools and tips and tricks, but I mean it really goes back to understanding your students, and really reading through their needs, and understanding how to best meet their needs. That's a whole episode, so we might have to do a crossover episode on that one!
Dr. Lynette Scotese-Wojtila:
Absolutely, I'm ready if you are!
Join the cast from Connect with Success for our first ever virtual event for Autism Awareness Month on Saturday, April 17, 2021. We’ll be highlighting those who have been champions of The Success Approach, talking to community partners, hearing special stories of those impacted by The Success Approach and a few more surprises up our sleeves. Be sure to follow The Success Approach for Autism Facebook Page for more information on how you can join this highly anticipated event!
Dr. Lynette Scotese-Wojtila
So our challenge for this week is to look for signs of readiness in the person that you know and love with autism. Watch for patterns that you'll learn about by looking at their eyes, listening to their voice, and watching their body. Try to imagine their readiness profile. What do they look like when they're really ready? That'll help you know, going forward, when they aren’t.
Dr. Richard Smith:
What struck me in this episode is that readiness is about gauging, if our audience, and in this case, our individual with autism, is ready to receive information that we wish to convey, as much as what to do if we observe that they are not ready to “hear us”, per se. Am I understanding this correctly then?
Dr. Lynette Scotese-Wojtila:
Yeah, I think the takeaways here are that readiness is observable. It's a state of preparedness that someone is ready to meet the demands of the environment. It's also important to remember that it's dynamic. It's going to fluctuate and we all have readiness states. And remember that readiness is not the same as skill. And that lack of readiness is going to limit a child or an adult's performance. And then most importantly, work with your occupational therapist, your professional team, to learn your child's readiness profile or how they operate. So when they're unready you can use the “just right methods” to turn that around.
Dr. Lynette Scotese-Wojtila:
We hope that you learned something today to help you on your journey with autism. We'll share more on our next Connect with Success podcast. Until then, expect success!
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