Checklists!

Checklists!

You may be familiar with "The Checklist Manifesto,”  little book by Atul Gawande, who is excited about checklists.  His idea in this book is that tasks like doing surgery, building skyscrapers, and flying airplanes are so complex that even the most capable person is bound to forget a crucial aspect of the process.  But, he says, people can limit their mistakes by using something like a simple written checklist as they go through the procedure.

I personally am excited about checklists, because the only thing I know that is more complex than doing surgery, building skyscrapers, and flying airplanes is the cognitive processing required to maintain day-to-day human interactions.  Consider that by age 9, typically developing children speak at a rate of more than five syllables--more than two words--per second (Sturm'>http://lshss.asha.org/cgi/content/abstract/38/1/47">Sturm & Seery, 2007), and that this torrent of words rides on a vaster swell of loaded nonverbal cues like tone of voice and body positioning. 

Yet we can forget about the complexity of language sometimes, because sometimes it comes easily to us and those around us.  But the truth is that learning to communicate and teaching someone to communicate can be, at times, frustrating, discouraging, and overwhelming.  It is a big job that we undertake, and we undertake it with the highest hopes and the highest aspirations: to connect with the people we share our lives with.

Amidst this task, I find calmness in checklists. There are many that I have found or made and now keep at hand, and consult regularly as I plan, carry out, and review a child’s speech, language, and communication therapy.  These checklists help you address a task that is huge, but keep you focused on something simple.  They give you a task manageable enough to ensure your, and the child’s success.  When you check something off the checklist, you know that you are completing the task at hand in the way that you planned, and in the way that you will be proud of.

Parents of children with special needs, I know that you are forever called upon to do specific homework activities or to practice new techniques for communicating with or teaching your children.  Checklists are a handy way to implement therapeutic techniques successfully.  I want to share three of my favorites here.

Checklist One: The book “Play to Talk” by James MacDonald and Pam Stoika has my favorite 5-step checklist for communicating and interacting with a reluctant or late talker.  If you find that you’re not getting as much communication as you want from your child, take time to ask yourself these five questions (paraphrased):

[] Am I balancing my communication so I say about the same amount as the child?
[] Am I matching my communication so I don’t say things that are too complicated for the child to say?
[] Am I responding to the child about the things that he/she is paying attention to?
[] Am I sharing control so that I choose activities half the time and the child chooses half the time?
[] Am I enjoying myself and showing that to the child?

Checklist Two: Especially when working with children and teens with autism, I adhere strictly to this 2-part checklist:

[] Would the chosen activity or routine be normal for a typically developing age-peer?
[] Is there one target communication skill for me to focus on? (Even though other communication skills may be improving through the activity.)

Checklist Three: The SCERTS model offers a beautiful list of “social-emotional growth indicators” that I think should be made into a universal checklist for all parents and educators working with children who have autism and other developmental delays.  Here is my adapted version of this list.  My suggestion is to ask yourself these questions and make sure you are checking off one or two of the items each time you undertake a therapeutic activity.

[] Am I attempting to increase my child’s happiness?
[] Am I attempting to help my child gain insight into his/her own thoughts?
[] Am I attempting to help my child gain access to information about other people’s thoughts?
[] Am I attempting to help my child find ways to cope with and adapt to challenges?
[] Am I attempting to help my child increase his/her mastery of an activity so that he/she can complete it without your prompting?
[] Am I attempting to bestow my child with friendships and a sense of belonging to a social group?

You take on a big job but checklists can keep your success rates high.  Happy checking!

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