He is 15 years old, non verbal, and has cerebral palsy. He can sometimes be aggressive and hard to control. His goals are to practice requesting items by using picture exchange, responding to simple verbal commands, and requesting his turn during social exchanges by using gestures/signs.

Most of the items I present to him he either puts in his mouth or throws across the room. I have tried toy trucks, various sizes of squishy, colorful balls, and even his favorite foods. He also just ends up destroying my laminated picture exchange photos. He really enjoys any kind of music and TV shows like Spongebob and Sesame Street.

I would greatly appreciate any advice or suggestions you have on how to treat these kinds of patients!!

 

My Thoughts:

These are my hypothetical suggestions I would try if I were working with a child like this.  Obviously, I can’t say what will work best for this child since I’ve never met him.

• Ditch the picture exchange: Sounds like that’s not an effective AAC system for him.  I’d try a big mac switch or some other simple, sturdy, voice-output device
• Ditch the toys: If he’s just throwing them, they won’t work for reinforcers (unless he loves throwing them so much he’s willing to communicate to get them back)
• Hook an accessibility switch up to a radio or toy that plays music.  Or, hook it up to a TV that’s playing his favorite shows:

http://enablingdevices.com/catalog/AdaptedElectronics/CD_Players_Boom_Boxes/cd-boom-box

Using Battery Interrupters to activate battery-operated devices: http://enablingdevices.com/catalog/useful-devices/battery_interrupters/battery-interrupters

• Alternatively, have him push a big mac that says “music” or “tv” and then turn it on for him.
• Alternatively, have him sign/gesture something that will tell you to turn it on
• Once he gets good at this, I would then make him respond to a simple verbal command (like clap your hands or look at me) before I give him the switch back to do it again