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Learning RPM - Case Studies

CASE STUDY: "Dylan"
DATE OF REPORT: 11/10/2006
AUTHOR OF REPORT: Student's RPM Tutor and Relative


1. STUDENT DATA:

Student Name: Dylan (real names withheld for privacy)
Date of Birth, May 3, 1995, Chronological Age: 10
School: Lincoln School Grade Level 5
Date of RPM start, May, 2005


2. FAMILY DATA:

Mother: Lilly Occupation: Lawyer
Father: Mike Occupation: Doctor
Siblings and ages: Grace 12 (13 in February)


3. STUDENT FAMILY BACKGROUND:

Dylan's mother is Indian and his father is white American. Dylan has a Hispanic nanny that has spoken Spanish to him since birth, but his parents have only spoken English to him. Dylan lives in an upper middle class neighborhood. His parents are divorced and he lives one week with his mother and the other with his father. His nanny goes back and forth between the two homes which are approximately 2 miles apart.

His mother is usually home on Fridays and the children spend Friday afternoon with her. He is very attached to his maternal grandparents and spends Friday nights with them. I am his paternal great aunt and have been working with Dylan since he was 3.


4 ASSESSMENT:

Dylan is mostly non-verbal although he can speak and has had continual progress in speech over the past several years. In the past 4 months we have seen an increase in his spontaneous speech. He is a visual learner, but, in my opinion, he has very acute hearing. Since he started going to school (in the middle of his third grade year), we have used two assessments to develop a curriculum for Dylan; his IEP and one prepared by an independent consultant. Both were ABA and VB based. Although we thought they were challenging at the time, we now believe that they did not challenge him at all. His curriculum was Special Ed and on a 1st grade level, working on money identification, calendar and weather, learning to tell time, touch math, and some computer work.

Dylan can read and has an extensive vocabulary. He is very interested in math and will always choose math first if given a choice. When I first began RPM with Dylan we both struggled with the format; it was new to both of us, but he hung in there with me and before long we got in sync with each other. Through the gift of RPM and the letterboard, we found out that he understands Spanish and watches the evening news in Spanish.

During my years working with Dylan I attend workshops and seminars on ABA, Floortime, and RDI; I was trained in TEACCH, and VB. However, after watching Soma using RPM I realized that it was the first one that really made sense to me; I attend the Level 1 Training Program that Soma offered in August, 2005. Once I completed the course, RPM fell into place for me. I saw the value of lesson plans and getting comfortable with the subject matter I was teaching. Dylan and I really hit the road running after August, and we haven't stopped yet.

We have shared tapes of Dylan doing RPM with his school as well as his other therapists. Although they were pleased to see them, they have not expressed any interest in learning more about it or using it to teach Dylan. We stopped seeing the outside therapists who had been working on academic skills, but kept OT,( 3 hours/week), Speech,(3 hours/week), Vision Therapy (once every 2 weeks), Music (1 hours a week) and Gym (2 hours/week). He continues to attend school for the social benefits. RPM is the only method we are using to teach Dylan academic subjects. He goes to school till 1:00 in the afternoon and I work with him till 4:00 at home.


5. THEORETICAL ORIENTATION:

Since his diagnosis at age 2, Dylan's parents tried every program that you can name from ABA to Interactive Metronome, listening therapy, and VB. Sometimes there were so many programs going on at the same time, it was hard to know if any were making a difference or if they were all helping. I believe that Floortime, which we began at age 4, had the greatest impact on socializing Dylan and bringing out the playful part of him. I saw glimpses of a delightful, sweet child, but I still could not get into his brain to find out how I could teach him. We began using an ABA/VB program with Dylan in fall of 2003, but progress continued to be slow.

Dylan's mom, grandparents and I attended one of Soma's seminars in Milwaukee in April, 2005. We watched her work with 3 children she had never met before and the changes that took place from session 1 to session 2, well that closed the deal for all of us. They went from screaming, kicking, and running away to walking in and sitting at the table, ready to learn. At the urging of her mom, Lilly called and enrolled Dylan in a camp in May.


6. GOALS:

Lilly, Hema and I took Dylan to Austin, TX in May, shortly after his 10th birthday. Soma said two things I will always keep close:

1. Autistic children are not mentally retarded
2. Learning is it's own greatest reward

Soma probed to discover how much Dylan knew about everything from colors to math, to geography. Suddenly I realized this was the path into Dylan's brain - Rapid Prompting Method. We went home and I began using RPM the next week.

Our goal was to have Dylan at a 5th grade level in all subjects by the end of 2005.


7. INSTRUCTION:

We now use RPM as the only teaching methodology for Dylan. The reason is clear and simple: RPM works. The changes in Dylan were swift and dramatic. He has gone from repeating touch math with numbers 1-5 in June, 2005 to multiplication, division and now fractions and geometry. The greatest change is that he talks to us using his letterboard.

Dylan has been back to see Soma 4 times since his first visit in May, 2005. We now are on a once every 6 weeks schedule. In the meantime, I work with Dylan every week day from 1:00 - 4:00 at home. His mornings are spent in school and he enjoys the social part of school, but his learning takes place in the afternoons. Dylan was introduced to the letterboard during his July visit with Soma and he began using it with me in September, 2005, and this became Dylan's voice. He is currently using it only with Soma and me. We have introduced the computer, and I believe this will become his future independent voice.

My guide book has been What Your 5th Grader Needs to Know. This series (it starts with 1st grade) of books do a nice job on history and geography as well as language, poetry and science. I started with 2nd grade and moved up to 5th in December. For math I am using Everyday Mathematics from McGraw Hill. We are using the 5th grade workbook. I also use additional material from library books or books of special interest to Dylan. We read age appropriate books, Tom Sawyer, Huck Finn, and now Harry Potter.

Dylan is working at a 5th grade level right now and will be doing 6th grade level during this summer. He will be using the computer as his communication device.


8. OUTCOMES:

Dylan can talk to us, using the letterboard. We can ask him what he wants, what he thinks, what is bothering him. This was the first Christmas Dylan told people what he wanted, and he told me what he wanted to get for everyone in his family.

Dylan told Soma he wanted to look smart. Well he is and he does. We have all seen the "new Dylan". He has feelings, he is kind, thoughtful, caring, sometimes angry, sometimes scared, curious, but mostly happy. Most people talk to him like he is 10, and that's new. I find him listening to what people are talking about, and we have conversations. Sometimes he will grab the pencil from my hand while I am in the middle of a sentence and begin spelling - he interrupts me!

His general behavior has also improved; he has gone from 4 or 5 temper tantrums a week to 1 or 2 every other week. We attribute this to his knowing that the people around him understand him and they expect him to act in an age-appropriate manner.


9. COMMENTS:

We now know that Dylan is very smart.



10. AUTHOR UPDATE: October 9, 2006

A little bragging and a big thank you.. A lot of good things have been happening with Dylan's progress.

After proving to the homeroom teacher and the Special Ed Administrator that he can communicate with a letterboard, he has been included in three classes in middle school. He is taking Science, Social Science and Math. They were most impressed watching him do algebra, and writing stories.

I shadowed Dylan and his aide for a week to make sure there was a smooth transition. I was prepared to spend more time there, but it was not necessary. His aide was not afraid to try the board and slid into it easily. He uses a rolled board most of the time, except with the numbers. The full board is used to begin the word when there is a test so there is no hint of an answer, and he then goes to 1/2 board. It has been working well.

Ok, here's the bragging - Dylan is getting all A's across the board!
They took a Science test last week and his score was one of the hightest in the 6th grade! People are coming up to me in the hall when I pick him up and introduce themselves to me, they all know Dylan and how he talks using the board. It is awesome.

Here's the big Thank You to Soma - you opened the door for us to reach Dylan, and what a wonderful person we found. Last Christmas he told his family what he wanted for Christmas the first time he has ever done this. It is the little things that keep us going, the "I love you" and "you are the best mom" the hugs. The little things become the big things and make the tough times easier.

The journey has only begun, but I feel that we are so on track.

Thanks HALO, Soma, Linda, for believing in our kids.
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CASE STUDY: EMB
DATE OF REPORT: 26 March 2007
AUTHOR OF REPORT: Student's Parent

1. STUDENT DATA:

Student Name: (last) B. (first) E. (initial) M.
Date of Birth: 19 December 1997 Chronological Age: 9
School: Byram Lakes Elementary School Grade Level: 2nd
Date of RPM start: March 2005


2. FAMILY DATA:

Mother: VGB Occupation: venture capital
Father: RCB Occupation: homemaker
Siblings and ages: GVB 13 years, CRB 10 years


3. STUDENT FAMILY BACKGROUND:

Our family of five is Caucasian, upper middleclass and English-speaking. We have three children who are touched by autism, two of them severely. Our eldest, GVB, is thirteen years old and considered "recovered" from PDD (a less severe form of autism) although she is still sometimes challenged in group situations. CRB is ten years old and EMB is nine years old. Both younger children were diagnosed by Yale's Child Study Center as being autistic on May 16, 2000.

Both CRB and EMB are now in mainstream public school with full-time aides. CRB speaks in short sentences and struggles with reading comprehension. He is a happy boy with a playful sense of humor. EMB is bright and sweet and would spend most of her day in front of a computer or video, if allowed. She is "in agony" (her words) with her inability to speak and will sometimes hit her head with her hand in frustration. Finding Soma, who taught EMB to how to communicate on an alphabet board, has been a great blessing to our family. EMB now can participate more fully in school and she can express her thoughts and desires. We want to increase the amount and frequency of her communication, but it is tedious, and she does so only when it is pressed upon her.


4. ASSESSMENT:

EMB was in a home-based Applied Behavioral Analysis / Verbal Behavior (ABA/VB) program coordinated by Douglass College since she was three years old. She made progress in this program with receptive language and the Edmark reading program. With a coordinator and staff of eight teachers (as the program was also for CRB) we had daily contact to assess progress. We worked closely with the school District and we all were pleased when CRB made enough progress to be mainstreamed into kindergarten with an aide.

However, EMB was non-verbal and Douglass recommended that she attend a school for autistic children in the fall of 2005. Our school District decided to start an autism class with Douglass College as a consultant that year. Unfortunately, the District hired a teacher who wanted to implement her own program. This resulted in EMB's programs being "dumbed down" so significantly that she started to have negative behaviors for 45% of her day (the teacher's data). That is when we went searching for a way for EMB to advance her learning and to demonstrate her intelligence. We visited Soma in February 2006. After that visit, we advocated through IEP and monthly staff meetings for EMB's programs to be moved toward a 1st grade curriculum. At the end of that year, against the recommendation of the Child Study team, we decided to have EMB enter 1st grade with an aide.

EMB is now in 2nd grade with an aide and she is thriving. At the end of 1st grade the school District gave her an IQ test and she is off the charts for her age group. She communicates by using her letterboard and an AlphaSmart communication device. She excels in science and math and attends a third grade math class. She is still greatly challenged in not being able to speak which inhibits her social interactions. EMB is in the school's SEEK program and she has a gift for writing poetry (on her letterboard).


5. THEORETICAL ORIENTATION:

As discussed above, the deteriorating situation in the District's autism class necessitated our doing something else for EMB. I remembered the story of Soma and Tito. We first saw Soma Mukhopadhyay more than a year earlier when she was featured on 60 Minutes.

In February 2006, EMB and I went to Austin to work with Soma. Over the course of 8 sessions over 4 days, we learned that EMB's favorite color is P-I-N-K, that she wants to be a T-H-E-R-A-P-I-S-T when she grows up, she wants P-I-A-N-O and D-A-N-C-E lessons, and likes H-O-R-S-E-S. Soma gave her math lessons with addition and subtraction, science lessons about wind and butterflies and reading lessons where she was conjugating verbs. This is all from a child that was stuck repeating over and over the same lessons in school that focused on motor instructions such as "touch your nose" and identify the numbers 1 through 10. RPM gave us an outlet for advancing EMB's education, while also providing a vehicle for her communication.


6. GOALS:

Since our first visit in February 2006, we have seen Soma four other times. Each visit we have had different goals with the overarching goal being fluent use of the letterboard for spelling her responses. On one visit EMB's long-time aide attended so that she could observe and learn the method. The aide has been a key to our success with RPM as EMB still does the letterboard more fluently with her than any of her family members. We have had many goals which we first achieved with Soma on one of our visits and then were able to achieve them at home. These include: writing a poem, conversing about spiritual matters, doing multiplication and division, and using her communication device.

It would not have been possible for EMB to be mainstreamed if we had not found Soma. Only with a means of communication could EMB complete the academic work. It has been a challenge for all of us, but our team of teachers, long-time aide and therapists have believed in EMB and understood when she is having difficulty. As EMB wrote in one of her sessions with Soma:

"School is not a good place some days. Other days it is fine. I can get so scared when I see other girls talking. I try hard, hard but can't talk. I can't say a thing and sometimes I freeze in front of the letterboard. I don't like being watched. I am most of the time."


7. INSTRUCTION:

EMB visited Soma five times from February 2006 through August 2006. Her aide works with her in school all day long and then comes to our home for another hour after school. RPM is used throughout the day. EMB is mainstreamed in 2nd grade and attends 3rd grade for math. EMB has begun to use an AlphaSmart communication device in recent months. She is now using the letterboard and device with teachers in school and her family members.


8. OUTCOMES:

EMB is best able to show her "outcomes." This is a child who was treated as if she was mentally-retarded, not communication-impaired. In this abbreviated transcript from one of her last visits with Soma you will see a child who is very aware of the world around her and a deep thinker.

Mom: "What would you like to talk about?
EMB: How can we see God?
Mom: That is a very good question and it will take us sometime to work through that.

Mom: What things in the world news would you like to talk about?
EMB: Who is Hamas?
Mom: That is the political party that just won elections in Palestine.

EMB: Who is FEMA?
Mom: That is the government agency that is helping the people who lost their homes in Hurricane Katrina.

EMB: How must war stop?
Mom: That is a difficult question. People need to talk things out.

EMB: Can I be Jewish?
Mom: Why do you want to be Jewish?
EMB: They are pretty. They have a good bonding with God. I am not seeing God now.
Mom: That's OK. We spend our whole life looking for God.
EMB: Finally I got to talk."

EMB is very aware of her differences and she has also accepted them. She expresses herself best in poetry and we continue to encourage her to write daily.

"Me

Can't they see what it's like to be me.
I am fine in this body of mine.
I just can't say what I would like to each day."

EMB is expected to attend college and have a meaningful career and life. She recently told us that she wanted to be a medical doctor so that she could help others.


9. PARENT COMMENTS:

EMB is a very bright and willful child. It has taken us the better part of a year to get her to communicate with us using the letterboard. It has been a struggle and she has often hit the letterboard out of frustration. She has told us that it is "tedious" to communicate this way and that she is in "agony" because she cannot speak. We are happy to have some method for her to communicate as we work on speech production.

She likes to read stories and write poetry. She is sensitive about such issues as global warming and war. We must give her opportunities to express herself and be mindful about what we say when she is around us, as she picks up things like a sponge.
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CASE STUDY: MH
DATE OF REPORT: January 31, 2006
AUTHOR OF REPORT: Student's Parent


1. STUDENT/FAMILY DATA:

MH was born 9/8/1995. He is now 10 years old. He attends public schools and is in an autism class with 6 students and 3 teachers. He is in 4th grade. His initial visit to HALO was in April, 2005. He lives with his mother, father, and older sister Jenny (11 years old).


2. ASSESSMENT:

MH was originally diagnosed with autism on his second birthday. He had developed normally until the age of 15 to 18 months when he started to lose his ability to talk, use his spoon and fork, pick up his toys, set his sippy cup down without spilling it, and most everything else. He is still non-verbal to this day. Besides having an official psychologist diagnosis of autism, the school also did testing. He tested at the age equivalent to less than 50% of his age. The test only went to 50%, he was below that. They said that mental retardation was from 50-75%. I asked what less than 50% was . there was no reply. He was off the chart.

Although we used ABA for several years and put him on all kinds of diets, he still tested below 50% on all his tests. He was becoming more observant and he did learn things however, it was over long periods of time. But due to the lack of words, he was unable to continue with his current programming. He used PECS (picture exchange communication system) to communicate. We were concerned however, just how far this method of communication could take him in life. He couldn't possibly have a picture for everything he felt or wanted to say, and even if he did, he could never communicate through writing or email. Due to his lack of motor skills, he could not let us know just how much he understood and had learned. To this point he had not become angry and was not showing any aggression because of his lack of communication, but we knew that unless we found another way for him to communicate, this too would change.

He was good at puzzles and enjoyed being around people. He didn't mind his schedule changing, and did not throw many tantrums. However, there were times he would cry and scream, and we would have no way of knowing what was wrong. It was a terrible feeling not knowing why our son was upset.


3. THEORETICAL ORIENTATION:

We saw a 60 Minutes special on TV in early 2004 with Soma and her son Tito. We realized that Tito (although older) was a lot like our son - yet with the RPM method, Tito was communicating through typing and had even written a book! Our son was completely non-verbal and only said approximations for "hi", "bye", and "mom" - maybe this type of training could help him to communicate better with the world around him. Then his life could be more fulfilling knowing that he could be a part of his community.

We attended a conference held by Halo in Philadelphia, PA a few months later and was totally blown away by what Soma was doing. She seemed to be able to use RPM on all kinds of kids. She said that she read to Tito everyday and always talked to him about things around him. She showed video where she used an alpha-board with kids so that they could spell out answers and what they were thinking.


4. GOALS/INSTRUCTION:

Immediately we went home and started to do these things. We read to MH each night, talked to him all the time in the car and at home, answered questions that we thought he might have, like: "We are going to the grocery store. . Yes, I know we just went, but Mom forgot to get butter . I know you would rather be at home, but I just need to grab some butter and we will go back." He enjoyed the interaction and would often laugh at jokes we cracked. Did he really understand that joke or was it just a coincidence? He understood.

Initially we had him type requests on an alpha-board. We would have him spell out "crackers" or "water". We would Velcro words at the top of the alpha-board and have him touch each letter than find it on the board. We found that he was typing the words but not going from left to right. (eg. "tape" he would type 'e', 'a', 'p', 't' or whichever letters he would find first). So we showed him how you had to go left to right. Slowly but surely he learned to type requests and we were able to fade the words at the top. We knew we needed more instruction, so we made an appointment for MH to see Soma at one of her camps in April of 2005.

Although we knew already that this method was working for MH, we could not have known the impact this trip would have on our lives. The very first session Soma sat MH down and asked him questions about the toy he had brought. "What color are his boots?", MH would select from the two torn pieces of paper with the words black and green written on them, he chose the correct answer "black". "How many fingers does he have?" she asked. MH chose "5", the correct answer again. Soon she was talking about numbers. "We count 1, 2, 3, 4, 5, 6, 7, 8, 9, . What comes next? Is it '10' or '2'?" she asked as wrote each answer on a separate piece of paper. Again, he chose the correct answer. This went on, she asked about numbers, seasons of the year, and days of the week. MH correctly answered every question. We were in shock. We didn't know his receptive language was that good, because previously he had no other effective means to express what he learned.

All through the week we learned more and more about how much receptive language our son had and his ability to learn. Soma taught him about prairies, how the U.S. mail works, luminescence, proper, common, and pronouns and much, much more . oh, my gosh! Why didn't we know that he had this capability? She had him pointing to spell on a rolled up alpha-board, if he had picked the answer "Cows" from the torn pieces of paper, she would have him spell "COWS" on the rolled up board. The rolling was essential because it only gave him a field of 5 letters at a time which did not overwhelm him. We were instructed to start this way, then we could slowly unroll the board and teach him to type on a flat board. We were sent home with instructions to teach him the same curriculum that other kids his age learn. Get the same books. He knows more than we think. We were stunned, elated, singing praises of joy, and calling everyone on our cell phone.


5. OUTCOMES:

At home we saw a big change. He would smile and act so proud if we were telling the story of what happened. His sister was excited too, since he had typed her a letter saying that he missed her while he was gone and that he loved her. He had cried when typing it! Friends said how he looked different, maybe it was because he was aware that his feelings count too. We asked his favorite places to eat, what he wanted to do on vacation, and all kinds of questions we had never asked before. Now we finally had a form of communication that could grow with his abilities and eventually enable him to communicate all that he wanted.

After a summer of working with him and teaching him new things, he was typing on a alpha-board, and we were ready for more instruction. We made another appointment for a camp with Soma scheduled in August. We had his ex-teacher come with us, she was amazed. She agreed to be MH's lead therapist and program his curriculum for his home therapy. There were many ups and downs. you see, MH did not really like that he could not sit at home and watch videos all the time anymore. He needed to learn. He was frustrated, but because we were told to only work with him 45 minutes a day, he stuck with it.

Less than a year from our initial visit with Halo, he would bring us his alpha-board to request things, "I want a tape". He also brought it to me to tell me he had a headache, and another time to tell me he has a stomach ache. We grinned from ear to ear as he told us for the first time what he wanted to be for Halloween - a vampire! Not exactly what Mom had in mind, but of course he was the cutest vampire ever! He told us he wanted Microsoft stock for Christmas - what a shock! He loves it when we read him the Wall Street Journal each morning. Who would have thought?!!!

Now it has been just short of three years since we first came to HALO, he is mainstreamed in 6th grade math, science, and social studies and getting A's! His aide helps him with the letterboard, and the last time we saw Soma she had him holding the board himself. He writes essays, tells me when he is mad, tells me I forgot his medicine, and talks about girls - all on his letterboard. He is handwriting, but still needs some prompts to initiate the next letter. He is also starting to use the Big Keys at school for the computer. We know that it will only be a short while before he will be completely independent in his communication.


6. PARENT COMMENTS:

I don't believe that MH is unusual, I believe that most non-verbal kids with autism have a healthy and active mind. They just need to be taught and given a mode of communication that is appropriate. He still needs help taking a shower, getting dressed, and some other functions that 'normal' kids already know, but now we realize that it is a malfunction of his motor skills and not his mental capacity to academically learn. We are constantly reminded of the old commercial, "A mind is a terrible thing to waste." We are so glad we found Halo and the RPM method for him to communicate and learn.

Yesterday, when I asked MH if he wanted to say something in this case study, he typed, "I am glad I went to see Soma". I guess that says it all. Our lives will be forever changed. Thank you HALO and Soma for changing our lives!
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