Section 4 - Far Ideas

When Day-to-Day Living Skills Become a Problem

Children with neurological issues often have problems with adaptive skills. These are the day-to-day skills we all need to take care of ourselves and get along with other people.  The skills include:

• Communicating with others.
• Learning self-care skills (dressing, eating).
• Having positive social interactions with others.

Adaptive Skills are things that are learned at home.  Everyone expects people to learn all these skills and to use them to take care of themselves. Sometimes children don’t do this the way we expect.   Then it is important to understand whether this is happening because a child cannot do something or because they will not do something.  If they will not, that is noncompliance.  If they cannot, it is a different problem.

Compliance vs. Non-compliance

Compliance means that your child does what you asked him/her to do. Non-compliance means that you ask your child something, but he/she does not do it despite knowing how to do the task. 

When your child is not performing a task, ask yourself if it is because he/she “can’t do” it, “doesn’t do” it, or “won’t do” it.  How you handle it should depend on what is really going on.

Use clear communication

Get your child’s attention before giving an instruction

• Make sure your child’s arousal state is calm and ready to attend.
• Look them in the eye before giving a direction.
• Remove distractions (i.e. turn TVs and computers off).
• Use a firm tone of voice.

Make sure your child understands what you asked

• Use directions that are specific and simple.  State what you want them to do.
• Do not say, “will you?" or "could you?"
• Use words and phrases on your child's developmental level.
• Use physical gestures to help with comprehension.
• Reward compliance. 
• When the child does what you asked, give him/her praise for their action. 

Deal with Non-Compliance using Time-Out

Here the goal is to remove the child from a stressful situation and let them calm down.

• Should be done in a relatively isolated area (hallway, kitchen corner, or living room).
• Important to only use time-out for non-compliance when you are sure that the problem is a “won’t do” problem.
• If a child “can’t do” something, like many children with neurological issues who will not comply with requests because they can’t do or don’t do the behavior(s), you may find yourself unfairly punishing the child.
• The duration of the time-out should be one minute for each year of your child’s developmental age (not chronological age), but can be adjusted to how long the child needs to become calm.

Overcoming Problems with Time-Out

• Ignore protests and crying. It is really important not to reinforce this behavior by paying attention to it. This is called accidental reinforcement.  If you pay attention, you will just get more complaints.
• Some children can take up to 45-60 minutes to calm down. If they go beyond this period, then you should look for approximations of calming (i.e., pauses, deep breathes). Then verbally praise those as if the child was trying to engage in them.
• Remind children they can leave time-out as soon as they are calm.
• You can use a visual timer to help the child focus on calming and understand that time-out will end when the pre-set time period is over or he/she calms.  
• If a child refuses to go to the time-out area, wait to start the timer.
• Stop the timer if the child leaves the time-out area.
• Do not leave the child alone in the time-out location. They will be more likely to get up.
• Remove other privileges if they won’t follow time-out rules.
• Provide physical support as needed with minimal social attention: walk the child to the chair; place hand on legs to maintain physical support to stay in place

Using FAR to improve adaptive skills

The FAR technique is designed to help a child understand a problem situation, organize a task, or get something done. It is called Metacognitive, because it helps the child with organization and planning.  Let’s talk about the three steps; Focus and Plan, Act, Reflect.

Focus and Plan.  By asking your child to Focus on a task, you are helping them learn ways to understand what is required and what tools they can use.  By learning to develop a Plan, the child learns what to do to solve a problem.  Learning about FAR, gives the child a way to stop and think about what they are doing.

Act. In this phase the child consults the plan and carries out a sequence of actions.  They learn to understand using a plan to structure their actions and to pause before doing something impulsively. They learn about doing things in the right order. The child develops the skill to link his/her thoughts to real world actions. This reduces your child’s impulsive and reactive responses.

Reflect.  When the child learns to Reflect, he/she thinks back on what was done and can check to see what worked and what didn’t. They can use this information to make a new Plan if necessary.  

How is FAR done with you child?

FAR Steps

• The child must be in a calm state and paying attention.
• The child is encouraged (reinforced) throughout each step.
• The child is taught what FAR stands for and what Focus and Plan means.
• You can help the child develop the FAR PLAN for approaching a task.
• It is important that the child be part of the planning. He/she should participate in the plan and have choices in how to do things. This will make the plan “theirs” and more likely to work.
• When you have a plan, it is time for ACT, letting the child carry out the plan.
• Then you will Reflect back on what happened during the ACT phase.
• The child should be encouraged to identify what worked and didn’t work.
• Encourage the child to recommend changes to improve outcomes next time.
• Then make a new Plan.

One important part of the FAR method is what we call interactive learning. It goes on during all the steps of the process. In interactive learning, the child takes an active part in the learning process with the parent or teacher acting as a guide.  That way, the parent lets the child learn but provides a scaffold (or structure), to support learning the right way.

What do you need to use FAR?  

• You have to intend to teach something. (You want the child to know something.)
• It has to be meaningful to the child.
• The child needs to respond. (You need to have the child’s attention.)
• You have to relate the lesson to other things. (This teaches the child to make connections.)

Remember: Your goal is to help your child think about his/her own thinking (metacognition). You are not trying to make the child memorize things and you are not going to do the job for him/her.  You are teaching the child how to do things for himself/herself in a way that will be successful.

When the child is working on a task, you may have to help but you want to do that in a way that will allow them to learn as much as possible and be able to do the task independently.  To support the child, you might guide them by asking questions as they work. 

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