Shadowing Day 6
Yesterday's theme was patience. I finally had my first experience with one of the residents being an enormous pain. Every minute, he would stand up and sign that he wanted a drink. We can't let him drink whenever he wants, becuase he
always wants a drink, and he pees himself if he drinks too much. So we had to keep telling him "no" and "go sit back down." He tried to stare me down a few times, but I would just repeat myself. As the day progressed, he became more and more noncomplient, so we had to start using a neck prompt to move him back to his seat.
After a few hours, he finally freaked out on me and started tantruming. His tantruming consists of screaming in my face, jumping up and down, and flailing his arms. You can't panic when one of the residents do that, because then they'll learn that tantrums get under your skin and they'll use that to his advantage. So, I kept my calm and turned to one of the more experienced staff members and said "Hey, I don't really know what to do in this situatioin" as the resident was screaming in my face. The other staff member forced the resident to sit down and did a couple of adverses to him while shouting "NO SCARING THE NEW GUY." He explained to me that alot of the residents like to test out new employees to see what works on them, and that's probably what was happening with this tantrum.
Yesterday I also had my first experience with pressing. The resident that presses often squeezes his hands and fingers together, so he has a bunch of scars and scabs there. He was acting pretty antsy throughout the day, so I had to keep telling him to relax. Then I looked over, and he was squeezing his hands together and his face was red. I went over to him and took his hands and put them on his lap and told him "No pressing, please. Sit quiet." If he hadn't listened to me, we probably would have had to shackle him until he calmed down. On one hand, I'm glad it didn't come to that, but on the other hand, I know it will eventually and I"m going to have to deal with it. It seems on every one of my days off is a day when he has to get shackled, so I keep missing it.
I also changed Bones for bed by myself for the first time. It was really difficult because he won't stay still and likes to grab and pinch me as hard as he can.
I also fed him for the first time today. He likes to spill things just to piss you off if you're not looking at him, and I finally had that happen to me today. The key is to not act mad, because that's what he wants.
Shadowing Days 4 and 5
Thursday, my fourth day of shadowing, can be described in one word: Uneventful. Nothing out of the ordinary really happened. I came in at three PM and there was a case worker from the state checking everything out. When the guys came home from work, Bones had an accident, so myself and the other intern got our first chance to change him by ourselves. Go interns! We spent the rest of the day doing various tasks around the house and finishing up the construction of a new computer desk. I was actually allowed to go home about a half hour early because there just wasn't much for me to do.
Today was my 9AM to 10 PM shift. The day went by
incredibly fast. Work at this job doesn't even feel like work, it feels like I'm a parent. I rarely find myself looking at the clock, and when I do, I'm surprised at how much time has gone by.
I'm starting to build a connection with the guys. I was talking to the guy that hired me, who's been working there for years, this morning. I told him that on Thursday, as the guys were coming in from work and I said hello to each one of them, one of the guys walked up to me and put his hand on my face for a moment. The guy that hired me told me that that's incredible because it took him years for that resident to be comfortable enough around him to do that. It made me feel really special.
The guys are also learning to stop poor behavior without me even saying anything to them. One of the guy presses, which means he applies pressure to his own body, which hurts him. If he starts doing that, or rocking back and forth, now I can just look at him and use a small hand gesture, and he'll relax and sit normally. Another guy makes noise and hand movements, so if I look at him, he'll stop and make the "quiet" sign with his finger up to his lips.
Today we rearranged all the furniture in the living room and cleaned up around that area alot. Some of the guys react to change by becoming very uncomfortable. One of them even looked like he was about to cry. I kept reassuring him that the room looked nice and that he'll get used to it.
Shadowing Day 3 and 1st Overnight Shift
Tuesday was my first full-length shift at the house, running from 3 PM to 10 PM. I arrived there at 3, since you have to get there before the residents come back from work. We made them snacks. When they came in, they had their snacks and then went to do leisure time, which usually consists of alot of sitting on the couch or on the porch.
One of the guys wet his pants, so I had to learn to procedure for bathing and changing him. It doesn't look like a ton of fun. I started bringing an extra change of clothes, because it looks like people get wet alot doing this job.
Then some of the other employees and I took a few of the guys out in the community. We had to get a vacuum from Sears, so we decided to take them to walk around in the mall. It's kind of nerve racking being out in the community with them, because it's bad news if something happens. We're not allowed to use any of the adversives on the guys if they misbehave, and if they freak out, we just have to try to get them to the van as quickly and quietely as possible. But the guys were good. One guy tends to wander if you don't keep an eye on him, but he never got far. Another guy walks really, really slow, which kind of splits up the group, but that wasn't a huge deal with so many other employees around on this trip. On the van ride home, they kept falling asleep, so we had to try to keep them awake, or else they wouldn't sleep at night.
After getting back to the house and having dinner, there was more leisure time. Some of the other employees were trying to build a computer desk for the living room and I was supposed to help, but I think the most I contributed was putting a few screws in. It's really interesting how the guys can just sit around watching TV when someone is banging a hammer right next to them without being really disturbed. At around 9, we sent two of them up to bed, and at around 10 we sent the rest up.
Then my overnight shift began. Since I don't count as a real counselor in the house, I didn't get to sleep in a staff bedroom, so I had to sleep on the couch in the living room. I was instructed to wake up one of the other employees if I heard banging above me, because that meant one of the guys was was probably doing self-injury behavior and would have to be restrained.
At around five thirty in the morning, I woke up to the guy with the bone disorder screaming in my face. Apparantly, Bones (we'll call him that from now on) had crawled from his room to my living room couch and screamed in my face to get my attention. That may have been the most horrible way I've been woken up ever. I didn't know what to do with him, so I walked him to the kitchen, sat him down, and then woke someone up to help me. We tried giving him something to drink, but he pushed it away after a sip. So we put him back to bed. About an hour later, I heard him coming from across the house. He was making the groaning noise he does, and it sounded like a ghost was coming for me. I intercepted him near the kitchen, sat him down again, and gave him something to drink, then put him back to bed.
At 7:30 one of the other counselors and I got up, started making breakfast, and started getting the residents out of bed. I learned which guys needed to be woken up first (since they take forever) and which guys need help getting dressed. The guys started to trickle downstairs for breakfast. One was taking forever, so I went to go get him, and found him standing around his room naked. I told him to get dressed and decided I'd give him another minute, because I didn't want to have to touch a naked person unless I really needed to. When I checked on him again, he was sort of half dressed. He had underwear and socks on, but his shirt was halfway around his head and he was just sitting on the bed. I told him to finish getting dressed and he complied, except he didn't zip his zipper. I told him to zip up, so he made the bed. I told him to zip up, so he got his shoes on. I told him to zip up, so he put his belt on. Then I told another passing counselor that I couldn't get him to zip up. She told him to zip up, and he zipped up. That didn't seem very fair.
One of the guys who has to wear a uniform to work wasn't wearing his, so we told him to get dressed. He took his laundry basket and went upstairs, but then returned, still not in his uniform. We told him again to get dressed, so he went upstairs. He returned with his laundry basked. We told him one more time to get dressed, and again he took the laundry basket and went upstairs, then returned with no uniform. I learned that he's very uncomfortable with wearing unwashed clothes, (and hey, who can blame him?) so his uniform was probably dirty and he was having some anxiety about wearing it. We told him to take a deep breath and calm down, which he did, and told him he could do laundry after coming home from work. He seemed satisfied with that arrangement.
After breakfast, the guys took turns going upstairs and brushing their teeth. Then we loaded them in the van and drove them to the work center, where they're then taken to their individual places of employment.
Shadowing Days 1 and 2
On Saturday I began "shadowing", which is when I spend 15 days working in the group home and being trained more before I can officially count as a teacher/therapist and be scheduled as such.
Saturday I spent 9 AM to 3 PM there. The residents were in their bedrooms for the first hour or two, so I read all of their learning program binders and learned about their medication. The manager of the house also gave me a rundown on each of the guys and their personalities, interests, etc.
They just started a new program for one of the residents in the event that he has aggressive behavior at night. We have to put him in a bunch of restraints and then strap him down to a big wedge-shaped pad. I was tied up to demonstrate how it worked. It's definitely pretty much impossible to get out of. I was able to get one of the straps on the wedge off, but that was it.
Then we went to the residents' rooms to get them out of bed and dressed for breakfast. There was much male nudity. The guys went downstairs and for the most part, were able to pick their own breakfast and feed themselves. Some of the guys would help the others pour cereal or juice. Then one of them would put the dishes in the sink. I was surprised how functioning they are. After breakfast, some of them went into the living room, and some went to sit on the porch. I was again surprised at how they seem to have no problem with just sitting around without anything to do. Two of them just sat outside for an hour without talking or reading anything or really needing any sort of entertainment. The rest of the day was a "quiet day", so we sat around watching Harry Potter on TV. I watched them eat lunch too. I also started giving verbal commands to some of the residents. One of them keeps tucking his shirt into his underpants, so I ask him to fix his shirt and motion for it with my hands, and he complies.
Yesterday I came in at three and stayed at six. Another trainee was with me, and to catch her up to speed, we had her put me in the restraints again. Then I finally got some retribution and got to tie her up. I spent the remainer of the day reading enormous binders on each resident's behavior programs and The Organization's policies. I also became more comfortable with interacting with the residents. One of them rocks back and forth nervously when he sits, so I corrected him with verbal prompts. Another resident has a horrible bone disorder, so he can't walk without assitance, so I walked with him a couple of times, and now I think I'm getting the hang of it.
Tomorrow will be my first full shift, and it will also be a double shift. I'm going in at three, so a normal shift goes until 10 PM. But it's also going to be my first overnight shift, so I'll be sleeping there and staying until 9:30 AM.
Day 4
Yesterday was day 4 of training. We went over how to spot signs of phsyical, emotional, and sexual abuse, and neglect and all these other bad things. If we even suspect anything and don't support it, there's a minimum jail time of six months. So I'm going to be a pretty huge tattle tale if I see anything.
We also went over how to dispense medication, the procedures for picking up medication, and how to store it in the house. Then we a bunch of tests on the above. I got a 100% and 98% on the written tests, so I'm pretty sure I'll be the best sub in The Organization's history.
We also received a bunch of of certificates. I have like four of these things now, I'm certified in everything.
Today was supposed to be first aid and CPR training, but that was cancelled, so I had the day off.
Tomorrow morning I begin "shadowing" at my house. Shadowing is when I work there for fifteen days but don't count as a real sub yet, since it's my learning phase.
Day 3
Today was Day 3 of training for The Organization. We had our practicum, which involved finally applying the tests we saw in the videos to an actual autistic student.
We had several different activities. The first was a trial-by-trial type, where we laid out three coins and asked the student to give us two specific ones, give us the one worth the most money, or give us the one worth the least.
The second type involved asking him to set the table, then using gestural, faded physical, and physical prompts when necessary.
The third type involved asking him to fold towels a specific way, and using the above gestures when necessary again.
After that, we had our written test. I passed, and now I have a certificate saying so.
Tomorrow we start medical training. I don't know how I'm going to do with that, because we don't get a lunch break. What am I going to do without my 20 minute nap in my car?
Day 2
Day 2 of training was today, and I brought my notes out of my car so I can remember stuff.
Today we talked about the Decision Model (EDM). It's a 5-10 day long observaion without intervention of behavior in a person so we can figure out how to deal with the problem.
Then we talked about the importance of reinforcement. To learn correct behavior, the students/adults need consistent reinforcement. First start with primary reinforcers (like food and drink), then try to move toward secondary reinforcers (congradulations,
high fives, tokens).
But lets talk about the fun part. Today we learned about adverses, aka physical restraining techniques aka
takedowns. Let's go over them.
The finger squeeze: Take the offender's finger and squeeze between the first and second point and it causes a quick, sharp pain. I wasn't doing it right so the trainer did on me, and I almost screamed like a little girl. I don't think I have the hang of it yet, because I tried it on my roomate and it just looked like I was trying to hold his hand. If you do it to someone's thumb, you'll break it, so don't do that.
The arm squeeze and calf squeeze: Grab the upper arm or calf, and apply pressure with your hand.
Don't squeeze with your fingers.
Hand flick and cheek click: Flick the hand or cheek of the offender. It startles them and is annoying.
Cheek squeeze: It's that move your aunt or grandma does to you when you're a little kid and they haven't seen you in a while. You know what I'm talking about.
Lip prompt: Just touching their lips with one or two fingers. Just startles them.
Lip squeeze: Squeezes the lips together.
Lip tap: Taps the lips real quick. Another startling technique.
Hair pull: Quick tug that can either be done up near the temples or down at the nape of the neck.
Waterspray: On soft stream, hold 12 inches away and spray. Don't offer a towel.
Noxious spray: This one's nasty. It's a bottle filled with a substance you spray in the offender's mouth. The botter can be filled with Crest Mouthwash (no more Listerine becuase that has alcohol), vinegar, baking soda & water, black coffee, unsweetened Kool-aid (that doesn't sound that bad), diluted hot sauces, or various sour juices. It's good to use a variety so they balance eachother out, and so the people don't get cavities.
Rubberband snap: Two methods. Either snap them with the band around your fingers, or put the band around their rest and pull it back to snap.
Crisis ManagementHere's what I was waiting for. Unfortunately, there weren't any cool judo throws or pro wrestling related maneuvers. We just learned the basket hold, and how to take them down if they get out of control. If someone comes swinging at you, you grab their arm, spin them around so their arms cross and you're holding the arms. You're behind them, then you sort of push them with your hip, and then you make yourself fall in that direction. Make sure your head isn't directly behind theirs, because then they can just headbutt you and break your nose. You don't to come home and tell your friends you were beat up by an autistic guy, do you? Keep your head away. When you both fall, roll so they're on their stomache. Then you straddle them, but not on their lower back or else they can't breathe. Go a little lower, and then bring their hands behind them, like they do on
Cops. It's no Russian Leg Sweep, but it will do.
Congradulations, now you know how to safely subdue an autistic person.
Day 1
Names of people and organizations will be changed due to HIPAA laws. My job will be referred to as The Organization.
As a requirement for my credited internship at The Organization, I have to keep a daily journal. I decided to make a blog for this since it's more fun to write in than a Microsoft Word file, and maybe people would be interested in working with autism and this could be helpful.
Today was the first day of training. Traffic sucked and I got there about 20 minutes late at 9:20, but I wasn't the last one there.
We went over the origins of the organization, then did a quick lesson on what autism was.
We went over several different important steps and techniques in Applied Behavior Analysis (ABA) and how to appy it to the students and residents of The Organization.
We were taught the ten-step "tests" we would give to residents in order to reduce stigmatizing behavior and also for teaching basic skills.
Tomorrow will be more interesting, because we're learning take downs incase the autistic guys get out of control.
I'm the only guy in the training, so I'm basically going to be beating up a bunch of girls. Or a bunch of girls are going to be beating up me.
