The Completely Un-Cooperative Child

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Any ideas for working with special needs kids with severe behavioural difficulties? I’ve just started work with a kid who apparently mostly says single words (although I have yet to see any), is extremely hyperactive (literally cannot sit still for more than a few seconds) and I’m pretty sure has cognitive issues although the mom says his only problem is that he had a conductive hearing loss for a while due to glue ear. I’m not buying it! In today’s session, he laughed non-stop throughout and refused to cooperate with anything. His previous speech therapist had done PECS with him so I tried that but he wasn’t interested. Wouldn’t choose an activity from the pictures, grabbed toys without attempting to request and when told not to, laughed hysterically and got up and wandered around. I’m at my wits’ end how to control his behaviour or get him to cooperate with therapy or what to try with him – any ideas? Ok, an update – I tried following his lead, giving him a few activities to choose from (cars, playdough, bubbles, light up ball) and modelling language for whatever he chose but even here I didn’t have much success. He didn’t stick with any activity for long, was all over the place, didn’t try to engage with me in play even when I played alongside him, and didn’t talk, make sound effects or imitate anything I said. And he tried to compulsively lick the playdough:-P I honestly don’t know how his previous speech therapist got anything out of him!

Here’s What I Would Try:

Take him to a room or area with literally nothing to do (empty closet).  Bring in one thing that you can control but that he likes (like bubbles, a snack, or a fun toy) and some sort of AAC that will allow him to communicate that thing.  It could be a picture of the object or a button that speaks the word when pushed.

Bring the child into the room and start to play with the item.  Ignore him until he starts to become interested in what you’re doing.  Eventually, if there’s nothing else in the room, he’ll have to wander over.

When he comes close to the object (because he’s interested), hand-over-hand the AAC (pointing to picture or pushing button) and say the word for him, then give him some of whatever it is.  When he loses interest, let him wander away and just keep having fun with the toy without him (but make it really obvious how fun it is).  When he comes back, do it all again.  Switch out the object of interest every few minutes to keep him engaged but keep everything else out of reach and out of sight (in a locked box?).

What Would You Do?

Leave your ideas in the comments to see what else we can come up with!