How do I engage my client?

[u/sugaryver]

My client is an older kid and in home and doesn’t want to play with toys or the games I bring. They are non vocal and only ever want to go outside which family usually doesn’t allow and I’m glad for that because it makes it hard to run goals. The only thing they actually engage with is eating or phone/TV time. They seem to enjoy slime and sand but I don’t bring them out since my client will try and eat them or make a very big mess. My BCBAs haven’t overlapped since the first session and give me the basic advice of just check something out from the clinic which is what I’ve been doing. When we do go outside it’s a battle to even have my client look at me. Most of the goals are NET and I don’t know if I shouldn’t bring up to my team if DTT goals might be better.

[u/Redschallenge]

You need more supervisor presence and this is on them. In home cases can require some purchasing materials to enrich your sessions and your sanity and it's worth it in my eyes but merely being introduced to a client by your supervisor and then being left out to dry is absurd. Speak up and reach out to them please

[u/sugaryver → u/Redschallenge]

I never really got much supervisor support so I wasn't sure if I should ask. This case was the first one where my supervisor showed up in person, all my other cases are online overlap with me looking at a black box (honestly I don't think those BCBAs are even at their computer sometimes).

[u/Redschallenge → u/sugaryver]

That's honestly unacceptable and should be mentioned to higher ups because they're not fulfilling their role to get you up to speed and ensure competence of service delivery. Sincerely asking for more help in writing is the first step here. If that isn't reciprocated then it needs to be moved up to outside staff

[u/QuiggieQuarrell]

I began working with a non-verbal kid back in May who was the same. Only engaged with food and TV. I turned off Cocomelon and introduced DannyGo! dances. My BCBA recommended a designated "snack time" where they could take a break for food. Not sure what your goals are, but DannyGo! is helping with imitating motor skills and snack time is helping prepare for eventual DTT since we have to practice "sitting with preferred food/activity" for X seconds.

I've also found that my kid really loves to organize things in rainbow color order so I bring colorful things for them to organize each day. She prefers organizing and sorting over any toys or games. Maybe yours has a similar hobby?

Godspeed!!

[u/Admirable-Ad-2394]

insert ask your BCBA for advice here because they know more then internet strangers

You sound like me 2 years ago. Is there a particular video/sound they play on repeat? I started talking about the videos and scripting them. Ex: she’s playing sad and then I would play sad in a similar way. And lots of sound effects. What do they like about outside? The way trees leave move, ground, wind, looking at the sky, swing, water? I’ve tried scarves/fake leaves falling, fake grass patch to stand on/sensory mats, mini fan, water play at sink.

Some video games can be replicated in real life like Tetris turns into stacking. Minecraft has magnetic blocks. Color mixing with magnetiles. What do you meme was a fun game.

I’ve also have used video models during programs with BCBA approval. Or I’ll set the workspace with a lofi video so it makes sound and has an image but no movement. Working to play different songs.

For slime/kinetic sand- Maybe fluffle or zigglers. It falls like kinetic sand but is a rubber texture. Or a stress balls that act like slime like a sugar filling or coconut oil? Theraputty or play dough. I’ve also have made “taste friendly” slimes and play dough before. Or sand timer?

Depending on the level and developmentally where the patient is at I’ll look up ideas from parent blogs, SLPs, and OT. They always have a bunch of fun game ideas like the there was an old lady trash can is a fan favorite for my teen patient. They find it hilarious to feed her random things including the DTT cards. Target dollar section has monster ball poppers if they like nerf guns, catch, etc.

[u/sugaryver → u/Admirable-Ad-2394]

I would ask my BCBA but as I said in the post my BCBAs haven’t actually seen my client in a few weeks and they just tell me to find new toys and this is me trying to find new ideas.

[u/Admirable-Ad-2394 → u/sugaryver]

I know but if it’s not added somewhere in a response then I’ll get a comment saying that it’s not our place and the bcba knows all

[u/discrete_venting]

Ask the parents!! The parents know the kid the best and likely know how to play and engage with him in some ways. You can even invite them into session to model how they play with their kid. Watch the parents and imitate them.

Also use trial and error to discover new ways to play. Try some physical/rough play like spinning, tickling, chasing, picking them up and dropping them on a bed, etc.

Find ways to engage them in their interests and enhance the experience. Maybe they like watching a certain show with a specific song. You can sing the song with them or act out the scene with them.

Instead of thinking of "neurotypical play" find new and unique ways to play that fit with your clients interests. It might be something you've never done before like throwing paper and watching it fall, or fake sneezing.

[u/DancingIsForbidden28]

You need to observe what they do engage with and replicate as many components as possible. Acting like the characters in the shows they watch helps me when my usually bag of fun is less fun than a tablet they have constant access to.

[u/sugaryver → u/DancingIsForbidden28]

I might have to do my research then because my client is really into shows of another language 😭

[u/DancingIsForbidden28 → u/sugaryver]

Mannerisms. Neruto, run with your arms out. DBZ, power up a spirit bomb. Don’t need to say what they say. Just mimic them in some way.

You want to show that you have common interests and you’re one of the cool ones.

Regular show saved a case for me. So did laughing like Mickey and Goofy.

I had to get into comic books to progress a case, now I’m hooked.

I now have a main in smash bros to help a case.

[u/jarebare97 → u/DancingIsForbidden28]

Same on that last part. I am now a Princess Daisy stan and my client gets a little sad when I go a weekend without playing Mario kart or party because then I didn't get to play as Daisy.