Program Suggestions

Hey team,

I'm posting this on behalf of Tita A. Happy New Year!


Recommendations:

1. It is good for Raffi to continue the program he is following now. He is getting adequate social/recreational exposure, daily living skills as well as life skills/vocational training (e.g. job at carwash). He also attends reading and math lessons every Saturday.
2. It is highly recommended, however, that instead of continuing to focus on developing basic academic skills, Raffi's tutors could make the shift towards developing functional skills in reading, writing and number concepts.

• Instead of reading primary books, Raffi could be trained to sight read important words in his life correctly and consistently. For instance, he could read his name, the neames of his parents and siblings, his address as well as "survival" words important in his daily functionaing (including warning signs). Functional reading skills also includes being able to read simple manuals and simple written instructions and carry them out. His therapists could initially make these manuals and written materials themselves as teaching materiales.
  
• Raffi could be trained to write his name, the names of his parents and siblings, his address along with other important words in his daily life. He also needs to be given a lot of practice in terms of writing legibly. This would include giving him activities that will address fine motor coordination such as tracing and copying tasks, coloring within boundaries, manipulating and forming with clay as well as picking up small objects that would require him to use his pincer grasp and so on. Although these activities may look like they are for very young children, care must be taken to make present these activities to Raffi in a more age appropriate manner. Raffi is quite sensitive and self conscious, typical of an adolescent.
  
• Raffi's command of number-quanitity relationships also needs to be further established. Focus could be placed on improving ability to manipulate money concepts specifically the cents (e.g. 1,5,10,25 cents), $1, $2, and $20. Math concepts of addition and subtraction could be taught under the practical context of computing money under different situations (etc. purchasing at a store, paying on a bus). Raffi could be taught to use a calculator

1. It is important that the training of these functional skills be done in a practical, on-the-job setting using concrete and familiar objects under structured, repetitive and routine situations. Rote memorization, repetition and practice as strategies of training could be employed, rather than deep processing, when teaching these skills.
2. Visual aids/prompts that show the sequence of steps of an activity Raffi is learning to do are one teaching strategy that could be used by his teachers. Raffi could be taught to deal with simple problem solving situations through self-instruction. "self-instruction consisted of statements that represent a verbalization of various aspects of the problem and its soluation." For instance, when faced with an unplugged light fixture, the self instructions involve the following: a) stating the problem ("light out"), b) stating the generic response ("gotta fix it"), c) stating the specific response ("plug in"), d) reporting the response ("fixed it") and self-reinforcing ("good"). (Mental Retardation: Nature, Cause & Management by Baroff and Olley).
   
3. Raffi's parents/teachers could also teach him "habits of employablity" or develop work-appropriate behaviour or values. These habits include: a) regular attendance, b) punctuality, c) getting along with co-workers and supervisors, d) accepting directions and correction, e) maintaining an adequate work rate, and f) showing concern for the quality of his work (Mental retardation: Nature Cause & Mangament by Baroff and Olley.) Raffi could be helped to develop these habits at the level he is capable of. Such values could be incorporated in all of his sessions by his various therapists.
4. It is important that meal preparation and simple cooking as well as taking the bus (for short and frequently taken routes) continue to be part of Raffi's goals in developing life skills.
5. Raffi could also be helped to expand his fund of vocabulary words. Again the vocabulary words could be made up of names of objects he sees in his environment, action words and names of places familiar to him. One way this could be done is to show him pictures and asking him to name them. If speech articulation is a porblem he could be encouraged to use gestures and demonstractions to "name" them.
6. Raffi could also be taught to define words more effectively using the following strategies: defining by means of physical characteristics (e.g. a bicycle has two wheels and a pedal); function (e.g. a bicycle is used to ride on); and category (e.g. a bicycle is one mode of transportation).
   
7. Asking Raffi to generate differences and similarities between objects could develop concept formation ablity. FOr instance, discussions at the dinner table on how car-boat-airplane differ (e.g. car travel on land while boat on water) could be conducted, followed by ways in which they are alike (e.g. all modes of transportation). He could also be asked to group pictured objects into categories and indicate his reasons for doing so.
8. Encouraging him to be curious about objects around him, how they work, where they come from, and so on could improve Raffi's store of general information. For example, dinner conversations could comprise of conversations designed to help increase his awareness of his environment and understanding of why things are done in certain ways (eg. why cars have seatbelts, why policemen have to wear uniforms, wh fatty foods are not healthy.)

It was a pleasure to work with Raffi. Should you have any questions regarding this report or if I would be of further assistance, please contact me at mcrznfernandez@gmail.com or 778.989.7011

Maria Corazon Fernandez, M.A., M.Ed.
Psychologist