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First/Then

EllenML

I am a SEN Learning Support Assistant to a child with autism. I'm fairly new to education and working with children, and particularly to autism, but have made great progress in the few weeks I've been in my job.

Something I'm finding difficult to get my head around, however, is the First/Then book that "my child's" autism support worker (from the council) insists I use. Whilst I realise that a lot of adults do say "He doesn't need that", when in fact, autistic child in question does need something, I really REALLY feel like the first/then book is not working.

There are a few issues:

  1. He is too forward thinking. He wants to know what is happening first and then...and then...and then...whereas the book only allows for the first activity
  2. The first activity may change very quickly and, apart from the fact that he struggles with change, I don't even have the chance to make the change of activity in the book before it's started and new, unexpected demands are being made of him.
  3. He doesn't seem that motivated by rewards. He won't get on with something because he knows something else is coming. I don't see it drives his behaviour.

I've pushed back a few times, trying to come up with alternatives, but keep being told I need to use it. It just seems pointless. And given that I spend the most amount of time with him at school, and she sees him once a week for 5-10 minutes, shouldn't she be listening to me when I tell her it's more of a hinderance than a help?

Has anyone else had experience of using this? How effective was it? Any tips on how I can better integrate it into his day?

Thanks!

Ellen

  • it does sound like your child maybe needs to use a visual timetable. If hes asking whats happening way ahead he probably has some anxiety and a visual timetable will help him/her menatlly prepair themselves better. still use the now/next when your motivators arent working. now we do carpet time, then reward. think about rewards too. my son didnt respond to much when he was very little - i dont know what age group you support. often things like stickers wont wash. I let my son chose his rewards and often use a star chart  to build up say 5 stars before he gets his chosen reward. obviously sometimes rewards need to be smaller and instant. does he have any special interests? 

    i would persue with visuals. sometimes its just tweeking how you use them, being consistent and using them in a certain way. 

    my son had always really struggled with dressing and id given up on the many different visual concepts id tried and failed with until an autism support worker said well are you using it right? have you tried this? and i tried it again and it worked a treat.

    good luck x 

  • Another illustration is Thinking in Pictures, and variants of this "what is little Johnny thinking" mentality.

    Yes it helps some people on the spectrum to compensate for lack of social feedback. But is there an age limit after which it is counterproductive?  And should it be used where children are better able to pick this up for themselves?

    These tools just seem to be a fall-back armoury for people who don't really understand autism and think going through some robotic process is constructive or helpful. It actually puts some young people off seeking help for the simple reason - instead of listening - some well meaning person wheels out little johnny - for the n thousandth time.

    What Thinking in Pictures is supposed to do is help people who cannot read other people's minds properly - hold on - are NTs "Mind Readers" then? Mind blindness has underlying causes.

    People on the spectrum do not get good social feedback because they aren't paying sufficient attention to facial expressions, aren't reading gestures properly, aren't making good eye contact etc.

    Thinking in Pictures cannot cure that. Nor does it address the converse that individuals on the spectrum have difficulty producing the correct facial expressions to back their words, producing the right gestures, and giving the right indications through eye contact. Thinking in Pictures is a one-way dialogue

    All Thinking in Pictures does is remind you of a deficiency. It may help people adapt and compensate. But using it inanely all the time is pointless.

    I suspect First/Then's main weakness is it assumes things about people on the spectrum that aren't necessarily so. And there's an awful lot of that about....

  • Thanks for your response. It's really weird because she seems totally accepting that not all autistic children are the same and yet tries to make all the Learning Support Assistants use this book. But with a visual timetable (which is very effective because then he knows how is day is planned out) she has told another LSA that her child doesn't need this because he's too moment-by-moment.

    This being the case, the other child being more moment-by-moment, then surely she can appreciate that mine isn't and so he needs further planning that what we're doing right then. It just seems like another piece of information I've got to give him when he's already got enough to get on with. Ugh. Frustrating!

  • I think it boils down to a simple question - are all people on the autistic spectrum exactly the same?

    The reality is that individuals vary greatly, some symptoms strongly present, some mildly, some absent, so that it is very hard to generalise.

    First/then is highly prescriptive. It may be very valid for children who have difficulty initiating an activity, who need prompting. But not all children on the spectrum need so much prompting.

    There also seems to be a rather oppressive element of punishment about this method, that it is being used to brainwash children to somehow learn their way out of autism.

    I don't think there is anything like sufficient understanding of how children deal with autism, even after decades of methods and research.

    As NAS is one of the supporters/providers of First/Then perhaps they could explain why they think it works.....