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Goals
without the right objectives is like trying to travel to a distant location
where you have never been, without a map, guide, or gps.
Objective. A behavioral outcome statement, developed
to address specific steps a participant will need to take to accomplish a
goal. An objective is written in
measurable terms that specify: the learner, the desired behavior, the cue to
signal the participant it is time to complete the behavior, a target date for completion (no longer
than six months in duration), and include criteria for successful attainment
of the objective.
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Contextually mediated is simply placing something in
context. In this case, placing the skill
into the setting and within the natural routine and with the natural caregivers
where it will be used.
Why is contextually mediated important… even
essential for significant sustainable progress and change?
For any of us, most of our actions, most of our
behaviors, are governed by our old brain.
Habits are controlled primarily by the basal ganglia. Our autonomic nervous system works out of our
old brain. Heartbeat, breathing, etc.
are all primarily functions of the old brain.
I say primarily because we can, using our cognition (new brain), stop
our breathing for a time and slow or speed our heart rate; but the primary
control still resides in the old brain.
Most of what any of us do from day to day is driven by
habit. Habits are primarily responses to
cues or triggers within our environment and natural routine. When you drive a car, most of what you do is
through habit. This is essential because
it allows your cortex to focus on potential dangers, such as the child running
into the street after a ball. Most of
our eating is also in response to cues and driven by habit. I go into a great deal more depth in: Avoid
or Reverse Type II Diabetes: Choose Health, Life, and Love: Food Addiction,
Binge Eating, Addiction Recovery (Sixth Edition or later).
Most of our habits are context dependent or
semi-dependent. Many of us sleep better
in our own bed than in a hotel or guest bed.
We typically function more efficiently in our own office, classroom, or
other familiar environment.
Let’s take a sleep deprived parent as an example. S/he may not be getting much sleep because the
child who has autism (ASD) is not sleeping well. A good therapist, providing excellent intervention,
first response would be to look for setting events. Things in the child’s life that may be
keeping him or her from getting to sleep quickly and sleeping well through the
night. These may be routines in the
home, medical conditions, diet, etc. If
there were no medical or dietary issues, this therapist would look to the
routines in the home and work to condition child and parent towards better
sleep hygiene and optimal sleep.
The therapist would understand there are or can be
natural cues or triggers within the home which can help, both the child and
parent. The bath and bedtime routine,
meal routine, ultradian rhythm, circadian rhythm, daylight and darkness, all
present natural cues that can tell the child it’s time to go to sleep. Within this natural routine are internal
cues, such as fatigue, and external cues, such as smells, sights, sounds, and
perhaps the warm, moist feel in the shower and the bathroom after the shower or
bath. There may also be natural physiological
changes that occur after drinking a warm glass of milk or eating some white
string cheese, banana, tart cherries, or consuming a small amount of melatonin.
Within this natural routine, some which an
interventionist may help create or adjust with the parent, are potentially
hundreds (no exaggeration) of cues which can help both the child and parent get
a better night’s sleep.
The same is true of other routines in the home, shopping,
at a restaurant, another family activity, and in the classroom setting. The closer to matching the natural routine in
the natural environment with the typical consistent caretakers, the easier it
is for the child to learn new productive skills. The more contextualized, the easier it is to
develop new, healthier, productive, habits.
There are hundreds, sometimes thousands of cues
associated with routines which help us navigate our world. Some of these cues are nuanced and slight,
some are powerful. Disregarding these
cues for the positive benefit of the child, significantly reduces the benefit
of any intervention.
Yes, it is important to generalize, but first create
positive productive habits contextualized within the child’s natural routines,
in their natural environment, with consistent parents and caretakers.
Once a positive productive habit has been established,
you can add variation. This may be
slowly or quickly. As you do this, you
will likely need to return to the old familiar routines, now habits, from time
to time or perhaps frequently. However;
you can begin to stretch the child beyond their new zone of comfort, creating a
wider and wider zone of comfort with variations on the routine and new skills.
(A much more expended view of setting events will be
discussed in an appendix at the end.)
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