There have been many blog posts devoted to Josie's difficulty with drinking and our attempts to get her off the feeding tube. Unimaginable energy has been spent on this pursuit by ourselves, countless therapists, medical professionals, and well-meaning friends and loved ones. Always searching for answers, I recently read an article on a behavioral occurrence called "Shaping" ("Helping Children Cope with Everyday Activities, pg 11). In a nutshell, shaping is when continuous reinforcement leads to a gradual change in behavior. Shaping can intensify an undesired behavior but it can also be used to ultimately move an undesired behavior in a positive direction. Essentially, a behavioral change can occur by having the child take gradual steps towards the desired outcome and using positive reinforcement (bribery) to celebrate each success.
Desired Behavior: Drinking (Pediasure, people. We're not "shaping" at a frat party)
Gradual Steps: We started with 3 drinks per meal, built up to 5 drinks per meal, and we are currently on 10 drinks per meal
Positive Reinforcement: Sunglasses (Josie's latest obsession)
Unanticipated Outcome: I may have misinterpreted the article; I'm not sure if my "shaping" technique is actually teaching Josie to drink or to count to 10.
Please excuse Josie's sumo wrestler hair - it's the quickest way to get her hair out of her eyes before breakfast.
I'd like Josie to hold the cup by herself. She can; she just doesn't want to. Once again, "shaping" involves gradual steps. Ultimately, I'd like her to receive all of her required fluids orally and no longer use her g tube. We're still a ways off but it's progress. I'm getting what I want, and Josie is getting what she wants so everything is cool!
Omgoodness, her voice is so sweet :)ReplyDelete
She's darling. I could listen to her count all day long!ReplyDelete
she is just the sweetest!ReplyDelete
That's no small thing! Excellent progress, Josie!ReplyDelete
So...our "shaping" is going to be saying sounds! Miss Sarah has become a little lazy and is back to the nasaly noise when she doesn't want to try! Now, to think about the bribery...the girls are getting so big!ReplyDelete
Counting and drinking, oh my Josie you are way past the frat parties! Go girl go!ReplyDelete
I can't believe how much she is talking and how smart she is! GO JOSIE GO!!!!ReplyDelete
Wow, Josie is an amazing counter! And her drinking skills are coming along nicely too:)ReplyDelete
Well done Josie!! You are SO cool:)
Josie is cool! But her mom is pretty cool herself...awesome job!ReplyDelete
Such a good job! Way to go Josie!ReplyDelete
I love it...she displays the same single-mindedness that my son does when he knows what he really wants! :) Great counting, and I hope you continue to make slow progress. We had to do the same when my son was just a weeeeeeee baby b/c his g-tube kept getting infected and leading to hospital stays. Those were some of the most intense, frustrating days of my life. Keep up the good work!ReplyDelete
So true that it works. We endured 40 hrs/wk x 2 months at feeding clinic and that is basically what they do (along with taking oodles of data to show they are using the right "shape" for your child). "Take your bite" "Good job taking your bite". Annoying to us after a while, but wow - intake of 100% vs the 20% we had on our own is hard to beat.ReplyDelete
Amazing what kids will and won't do. I can't believe her counting abilities and how well she talks, but then ah to drink from a cup, you've asked too much. Josie is clearly one smart, determined cookie. My son (3.5) was as determined to not learn to count as Josie is to not drink from that cup on her own. Maybe I should have connected the counting to say eating - he likes to do that.ReplyDelete
Love your blog! This episode is so wonderful, and so entertaining at the same time, that I had to send it to my 23 year old daughter to watch. She did...twice in a row. We both love that Josie says "glasses" are what follows "one". I have a niece, Becca, with Down's and found out about your blog via my sister, Chris.ReplyDelete