Snap Shot

Process recording

Client: Client A

Intern: Becca

Date: 2/13/11

Location: Social Work Interns office

Pre-engagement:

For this session with Client A I looked into more activities that I could do that would engage him in more physical activities. I also looked into more things that could be done to help with him with focusing.

Narrative:

Client A came into the office today very hyper. He ran down the hall straight into the office without waiting of his mother to follow him. We started out he session by playing Jenga. A game where Client A is able to build either different structures or play the way the game is intended to be played. While playing Jenga Client A tells me about a fight that he had with his brother this morning in which his brother scratched him and he scratched his brother. I asked him what happened and he said that his brother just scratched him for no reason. We continued to play Jenga until the tower got knocked over and Client Adecided that he wanted to build a house instead with the Jenga pieces. After we finished playing Jenga we played Candyland for a little while. I won the first game and then Client A won the second one.

Since client A was being so hyper today I had to reinform him about the reward system that we have. I told him that everytime he broke one of the rules that we came up with he would lose 5 points. If he lost enough points he would not get a sticker at the end of the day that would be added on to his sticker chart. I reminded him that he was working towards a toy robot. After we had the conversation about the toy robot things started to get back on track during our session. He also gets extra points if he behaves during the session. I reminded him that every time he does something good such as waiting to speak until I am done speaking or waiting his turn while playing a game he got extra points. Which in turn allowed him to get an extra sticker at the end of the session to take home with him.

After we were done playing the board games we played a freezing game where each of us has to make the funniest face and freeze with out funny faces. The first way we played was to see who could hold their funny face for the longest. After we did it that way we decided to try and play it for a certain amount of time. First we tried to hold our funny poses for 20 seconds. After we got 20 seconds Scottie wanted to try and do it for 40 seconds. He didn’t make 40 seconds of standing still but he tried.

Since client A was able to get and keep enough of his points during his session he was able to get a sticker to take home as well as a sticker to add to his chart to work towards the toy robot.

Assignment #3

Blog #3

My individual client that I am doing my intervention with is a five-year-old boy with ADHD and odd (oppositional defiance disorder). Through out this paper I will refer to my client as child A. His mother brought him in at the beginning of the year because of impulsivity during class as well as at home. I went through a couple of different measurements before finally figuring out what measurement I was going to be using for this project. The initial measurement that I started with was the freeze game. Unfortunately the freeze game became did not work well as a measurement tool. After testing out many different activities with my client I decided that a reward system would work the best.

Since starting with my client we have been doing a sticker chart. If he behaves throughout the entire session he gets two stickers at the end, one to put on his chart and the other to put on his hand. The chart consists of stickers and a goal. The goal is if he gets eleven stickers he will receive a bigger prize, which he has chosen to be a robot. Child A and I discussed what it meant to behave during our sessions in order to get the stickers. Together Child A and I wrote out a rules chart and both signed it. The rule chart consisted of rules such as taking turns talking, keeping our hands to ourself, follow rules while playing games, etc.

Each session child A starts with 50 points. Every time that one of the rules on our sticker chart is broken he loses 5 points. If he does something great and follows rules he gets 10 points. If he ends the day with 80 points he only gets on sticker and he can chose whether or not that sticker goes on his chart or on his hand. If he gets down to 40 points he doesn’t get any stickers for the day because he has broken too many of the rules. Every time that Child A loses a points I inform him of why he lost the points and how many points that he has left. Everytime that he gets more points I explain to him what he did write and give him a high-five as well as points. This way he is able to keep track and be fully aware of where he stands in terms of getting stickers for that day.

According to a paper written by Saul Axelrod at the University of Connecticut, children with behavior problems will behave better within a classroom setting with token reinforcements. Although the tokens have little value, if you accumulate them you are able to buy something better within a classroom setting. One of the advantages to token reinforcements is instant gratification. Since token reinforcement provides instant gratification a child is able to get feedback and reinforcement instantly. The children within the classroom are able to know exactly when something is being done correctly and when they are behaving. This essentially will help them associate good behaviors with tokens. (Axelrod, 203, 1971).

Another study that was done by STEPHEN D. A. HUPP, DAVID REITMAN, JOHN NORTHUP, PATRICK O’CALLAGHAN, MONIQUE LEBLANC at Louisiana State University stated that sportsman like behaviors were increased when they were accompanied by praise and tokens. This study was done with young children who were diagnosed with ADHD. This in turn can be taken to mean that when the tokens and praise were given to the children the desired behavior occurred more often. (Hupp et. al.,2002). The reinforcement of appropriate behaviors with rewards is the same thing that I am doing with my client in our office.

A third study that shows that rewards as reinforcement has been a proven theory to work with children with ADHD was done by Van Lier in 2004. In his stude he took 24 first grades without a diagnosis of ADHD and rewarded them each time they did appropriate behaviors within the classroom. This was done during “good behaviors games” The program was carried out for 24 months. After 24 months the ADHD related problems had decreased within the classroom compared to the participants within the control group. (Miranda, 2006).

The theory that supports this practice is behavior modification. Behavior modification is taking the undesired behaviors of someone and attempting to modify them to become desired behaviors. By rewarding the child’s positive actions he is able to learn what they should be doing with reinforcement. They begin to associate rewards with good behaviors. Hopefully as the child continues to get rewarded they want to do more of the positive behaviors in order to get more rewards ultimately making the negative behaviors become less and less.

Work Cited

Axelrod, Saul. (1971). Token reinforcement programs in special classes [Exceptional Children, 1971. VOl 37. n5 pp 371-379]. Retrieved from ttp://books.google.com/books?hl=en&lr=&id=6- vnZJjtBGUC&oi=fnd&pg=PA192&dq=behavior+modification&ots=u0yiG83ecr &sig=u5DHIXT-G5hZPDF_48ryXwvEofE#v=onepage&q&f=false

Miranda, A., Jarque, S., & Tárraga, R. (2006). Interventions in school settings for students with ADHD. Exceptionality, 14(1), 35-52. doi:10.1207/s15327035ex1401_4

Stephen D. A. Hupp, David Reitman, John Northup, Patrick O’Callaghan, and Monique LeBlanc. The Effects of Delayed Rewards, Tokens, and Stimulant Medication on Sportsmanlike Behavior with Adhd-Diagnosed Children Behav Modif April 2002 26: 148-162, doi:10.1177/0145445502026002002

Assignment #2

For my project for this semester I have chosen to work with my individual client. My client is a five-year-old boy with behavioral issues. I have been working with him for about three months at this point. In order to make this evaluation different we have started to focus on different and more specific issues. There are many different things that him and I have been focusing on throughout the semester. For this project I have decided to work on strategies in order to help him focus more during class.

My client was brought in last semester by his mother because of behavior problems that he was having at school. He is very impulsive and has a hard time focusing in class. He also has a very difficult time in the lunchroom because of the overly stimulating environment. He has a history of biting and hitting other children. The biting has stopped and the hitting is no longer and issue. He tends to threaten children but doesn’t hit them anymore. He tends to disrupt other children while in school, which has caused the teacher to isolate him during class. Because of the issues that he was having in school his mother decided to get him evaluated by a developmental psychologist. After going through the testing with the psychologist, he was diagnosed with sensory integration issues as well as ADHD. The specialist recommended that he get occupational therapy as well as social therapy. He will be starting with all these services later in the year or possibly the beginning of next year. This history/baseline phase involved both my individual client and his mother. (Bloom e.t, 39, 2006).

The behavior that I have chosen to help my client modify is the ability to focus. My client has a really hard time sitting still even for just a few seconds. Since he has a hard time sitting still it makes it very difficult for him to focus during class. The goal that we have made for him is to increase the amount of time that he is able to sit still in order to help figure out how we can increase his attention during class. This is an observable action. During previous sessions we have had together I notice how hard it is for him to sit still. When he sits in a chair that spins in my office he is constantly moving it through the entire session. I am able to measure the exact time that my client engages in attempting to focus during a specific activity in my office. Since he is so young the easiest way to perform the measurements is for me to do it myself while we are in session together.

My client is very excited to participate in this evaluation. Although he does not completely understand what the evaluation is he is excited to get to play a new game each session. He knows that we will be doing an activity in order to help him focus more during class. My client is very aware that he has a hard time sitting still and concentrating during class. He has stated it to me before saying that he has a hard time remaining in one position. When I explained to him that we would be playing a game during each session he got even more excited. He is excited to be working towards a prize that I have promised him if he follows the therapy rules that we have. Every week if he plays the game and participates in therapy he receives a sticker on his sticker chart. When he reaches eleven stickers he gets a robot toy that he chose earlier in the semester.

After discussing this project with my field advisor I was initially going to be doing this project with my individual clients mother who is also one of my clients. I had problems with this because she has been very inconsistent with attending her sessions. Although her son comes regularly she does not. Because of this I was very worried about being able to do the measurements with her. Therefore I decided to switch the client to do the evaluation with. Since switching the client I have not had an opportunity to speak with my advisor and discuss the evaluation directly. Previously though my supervisor and myself have discussed doing these freezing activities with my client in order to help with focusing and attention. My supervisor helped give me the initial idea of doing this activity with my client in order to make it both fun and helpful for him.

My next blog for this class will discuss the specifics of my intervention.

Reference List

Bloom, M., Fischer, J, Orme, J.G. (2006.) Evaluation Practice: Guidelines For The

Accountable Professional. Boston: Pearson.

Assignment #1

The agency that I am currently interning at is the Y. The Y is a non-for-profit agency serving the surrounding community. It is a non-sectarian Jewish Agency that offers many different types of services and programs. The Y serves many different populations. It also offers many programs specialized for individual populations. The Y offers programs in Chinese, Hebrew, English and Russian.
The Y offers many different types of programs. They offer programs for older adults, children, teens, new immigrants, and toddlers. These programs include educational, social, fitness, cultural, trips, and summer and winter camps and after school programs. There are also specialized social adult day center programs. These programs include two meals, fitness activities, case management, swimming, transportation, art, music, and inter-generational activities. There are two different social adult programs, one in Mandarin or Cantonese and the other one is in Russian. The Y also offers programs for children with special needs on Sundays.
I work with many different populations at the Y. I work with senior adults doing social discussion groups. We meet Monday mornings and discuss current events as well as different topics that interest the individuals within the group. The other program that I work with on Mondays is the after school program with the Chaverim program. This is an after school program that focuses more on getting homework done. On Tuesdays I work in the Alzheimer's respite program. I am the peer leader of this group. There are four different interns in the group and I am in charge of coordinating the sessions as well as planning what the different activities for each day will be. The Alzheimer's respite group is a group where individuals effected by Alzheimer's can come and get stimulating brain activity as well as socializing. Tuesday afternoons I work in the after school program for the Hebrew Language Academy. This is a specialized after school program that mainly just for the children who attend this charter school. The homework help is aimed towards the classes offered at this school. The last group program that I do is called Sunday Funday. This is a socialization group for children with Autism or who are on the spectrum.
My internship also includes two individual clients, a mother and her son. I have been working with the son since November. I just started working with his mother in January. The son just got an IEP at school and is going to begin services at school. Since I don't want him to become confused with all the different services he is receiving I have decided that its best to stop counseling with him and to continue counseling with his mother. I started working with the mother initially because she would come in and talk to me about everything looking for help when I was only counseling her son. Also her son is five years old and behavior modification therapy is only going to be effective if the parents are also involved. After beginning to discuss all of this with his mother I realized that there were deeper issues in the home then just her son's behavior problems.
The client that I am going to be using for my project this semester is the mother. She has attitudes and behaviors that I would like to change. We are going to have to work through her issues with having a son with behavioral problems as well as her actions towards her son in the house. We have to work through the ideas that behavior and intellect are not connected. There are many different things that the mother and I will be working though this semester. I will have a chance to see this client at least 8 times before the semester ends. Hopefully I will have the chance to see the client more then that before having to terminate with her.