A Wonderful Workshop

Today started off being a hectic day with finalizing everything for the workshop. We managed sorting out a beautiful tent and an lcd screen for the powerpoint presentation.

At 10am parents started walking in, and because many were stuck in traffic, we waited until 11 then started the talk. Emily did great, as I knew she would! The questions were asked during the presentation which led it into many discussions during the talk. The parents got some great information and spent plenty of time after the workshop just talking to each other and sharing experiences. We provided lunch then moved on to the workshop for the teachers and professionals after... this went even better I'd say. There was plenty of information that was given out and lots of ideas for the classrooms. Emily did great with this too.

Unfortunately we had a huge thunderstorm on way towards the end of the talk, and tried to rush through in the end, but still got through everything. After the talk, the teachers and professionals got to meet with each other as well, and I had so many of them approach me to say that they loved it and really wish that we'd have more of these. They were very impressed with the work Kaizora is doing and with the Global Autism Project.

We had given out evaluations for everyone to fill out, and majority said that they definitely want more of this. Some said that just discovering Kaizora has been a huge relief for them.

Basically, things went great and everyone was happy. I will try and put effort into having more workshops at Kaizora and spreading the word more. Now that Emily has been in here and we plan on finalizing all the children's programs, I will be able to take out more time into such events. We're all really sad that Emily has to leave us, but we're all holding our breath for her to make her way back very very soon!!...


Pooja Panesar
www.kaizora.com

In-Home Services!

Today began with a trip to a different part of Nairobi for Kaizora's first in-home session ever!!!  Addressing this need has been a challenge in the past, as staffing and transportation have not made this possible.  However, it is clear that there are more and more families asking for such services, so this is a gap Kaizora would love to fill.  This particular case is a 4 year old kiddo from the Phillipines who just moved here with his family.  Given his location relative to Kaizora, the family was unable to come daily, despite their desire for him to receive daily ABA.  As a sort of pilot opportunity, Kaizora has agreed to provide in-home services 2x/week.

When taking into account the advantages, this could be a good opportunity for generalization of skills taught in the center, an opportunity to include self-help and toilet training programs, and provide the father, who cares for the boy at home during the day, with some modeling and coaching, as this is an area he felt as if he wasn't as skilled in.  This session consisted primarily of observing him in the home, getting a feel for his routine, and getting him comfortable with trainers being in his environment.  Things went really well, and what is clear is that the boy seems eager to learn, and the father is very receptive to feedback.  I became inspired that things could work well when the boy grabbed his father's hand and led him into the kitchen towards the fridge, we prompted the father to ask the boy to say "open please", which he did, and when the father did so, the boy grabbed a bottle of coke and handed it to his father.  The father said "no coke" and closed the door.  The boy instantly tantrummed, throwing himself on the floor screaming and crying.  The father tried to redirect the behavior by looking at the boy and saying "it's ok, come on, let's leave, it's ok, it's ok, it's ok".  I asked the father "what would happen if he just walked out of the kitchen?", and the father said he had never tried it before.  I said "let's try and see?".  He walked out of the kitchen, and approximately 1 minute later the boy came out of the kitchen, plopped on the floor, looked around, walked to a roll of paper towels, ripped one off, wiped his own tears, threw the paper towel in the trash, and climbed on the chair and got his cup of water and had a few sips.  We of course gave the father lots of praise and he seemed content.  The father is apprehensive about his English skills, especially given we have talked to the family about only using one language to facilitate language acquisition.  Nonetheless, the father seemed content with the day's session, and after leaving the team from Kaizora was thrilled about the prospects of subsequent sessions.

Upon returning to Kaizora, we met with a family from Zimbabwe who has a 6 year old son with Cerebral Palsy with severe physical limitations on the left side of his body.  His leg has virtually no muscle structure, and his mother is taking him to South Africa in a month to receive a botox injection in his leg.  There was a lot of clinical problem solving around how to increase functioning on the left side of his body, including me contacting a Doctorate-level Physical Therapist in the United States with extensive background in working with children.  She offered many helpful suggestions based on the most current research in Physical Therapy with regard to complete vs. incomplete hemiplegia, motor planning abilities and spastic vs. flaccid CP.  She informed us of a growing body of evidence in support of "constraint-induced therapy", which basically entails putting the unaffected side of the body into a position to essentially make it non-functional, and incorporating fun activities into tasks such as pulling a rope, pouring water back and forth between cups, riding a bike with straps to keep his foot on the pedal, stacking blocks and pushing magnets all over a wall.  Hopefully as the kiddo is able to make more use out of the left side of his body, he will be able to participate in more activities with his peers, and subsequently gain more self confidence.  A program will be put in place incorporating ABA tasks and programs and prompting more use out of the left side of his body.  Ultimately, of course, the parents would like to see him go to a mainstream school with the rest of his peers, while still being able to receive the most out of his schooling environment.  We also agreed to meet with the school teachers and his aya (aide) in order to replicate tasks like those at school in the center so the goal can continue to be mainstream placement.  We were able to run many sessions with this kiddo later as a team, and what was also evident is the desire for him to compensate the best he can given restrictions on his left side.  We ran Precision Teaching sessions, and prompted lots of motor imitation in the context of his preferred activities, such as peek-a-boo, high fives, raising arms above the head and cheering and manipulating objects with his hands.  His left side upper body is much more functional than his left leg, and his mother indicated that when he had botox previously on his leg, his stance and walk was much better.  The team is excited to see how this round of botox affects his muscles in his legs.

Overall the day was very good, and there was lots of opportunities for in situ clinical problem solving and development.  We had the chance to record some sessions so we can review later and provide feedback later and review with Molly back in New York on Skype.  Pooja was hard at work trying to ascertain a large selection of reinforcers for the kiddos, and pairing these reinforcers with pictures she made on cards so they can have some meaning as we implement "First, Then" boards.  Way to go team!!
- Emily

Expanding Services

Today I met with a family from Somalia who came to seek my advice on how to support their 4 year old son in school.  The principal of the school feels that the child has "borderline autism" and the school may not be able to provide the support the boy needs.  After probing quite a bit and getting some background information, it sounds like there are many variables that could account for some of his delays academically and with his speech.  They said they had him screened for autism almost a year ago, and no diagnosis was given.  The principal would like to see the family get a second opinion, and I advised the family that it couldn't hurt to either rule it out or rule it in, for their own knowledge, but they should be very careful with how they disseminate that information, as it could cause him to be viewed and judged based on his label, not on his skill repertoire and abilities: it should not matter whether he has autism, what matters is how he is functioning relative to his peers, and his success in the classroom.  They asked what they could do in the meantime, and I suggested they have consistent contact with the school teacher, and the principal so she does not feel as if she is being left out, and target areas as needed and proactively as possible.  The break time between terms would be an ideal time to help him in areas he may be lacking.
What was positive was that the family was not plagued and concerned with the possibility of being diagnosed with autism, but instead want to use this knowledge to provide support where it is needed.  This meeting sparked an already determined interest in understanding diagnostic criteria, and how this information is then used to guide families towards resources they may need.  Perhaps if there is more awareness surrounding appropriate and accurate diagnosis while taking into account cultural differences and practices, maladaptive behaviors and developmental milestones can be targeted earlier, increasing likelihood for success throughout life.  Pooja and I also had the chance to take a closer look at specific clinical practices for specific clients, specifically shaping skill acquisition for a child with cerebral palsy.
We developed "First, Then" visual aides, and worked with staff on how to make access to powerful reinforcers contingent on appropriate responses.  Upon speaking in depth with the trainers at Kaizora, a targeted clinical training need during this trip will be the principles of reinforcement, planned ignoring and extinction.  Subsequent to this, in an effort to provide staff with more tools in order to make data based decisions, further training will be done in how to conduct preference and reinforcer assessments, and how to use this data to support skill acquisition.
This has further implications to create for Global Autism Project a structural training module and protocol for use at each site, based on the BACB's BCBA task list as well as personalized systems of instruction and inter rater reliability.  Another area of need appears to be logistics in terms of being able to provide services to everyone who needs them in all areas of Nairobi.  There are many families that have come for assistance, however logistics in terms of distance, transportation, etc, prevent them from being able to receive services consistently.

- Emily

Everyone's Learning!

Today has been a great day. We're all working together really well, the atmosphere is charged with positive energy and everyone is learning :)
Emily had a great consultation with a family this morning and gave plenty of great advice as always. I started sessions with a 4 year old boy today. We came up with ideas on what to run trials for and I feel quite confident with him. We're putting a first-then chart for some of the children and I'm quite excited to see how that goes. I think it'll definitely iron out some behaviours with harry.
I then had another consultation, which brought into limelight one of the main obstacles for parents getting therapy at kaizora... Transportation and traffic logistics. So many parents can't bring their children from across town for a couple of hours of ABA therapy and take them back. I hope that kaizora can one day provide full-day services and transportation as well. There are many we still have to reach out to.
After sessions, Emily worked on the workshop and we did some brainstorming together... And I went on to make some materials for the children.
I really enjoy working with Emily... We seem to be in tune when talking to parents or brainstorming about ideas... I really appreciate all she is has come to offer to us and am eager to soak it all up!!!
Tomorrow we're going to start our first ever home-based therapy and I'm looking forward to this new chapter for Kaizora.
:)

Pooja

A Day of Clinical Developments

Today I had the opportunity to get into some sessions and observe fluency based precision teaching as well as some discrete trial training. It's so amazing to see the skype training we have been doing for the previous month prior to coming being put into action-- I never thought I'd see the day when I would be seeing therapists in Kenya taking data on standard celeration charts!! I also was able to see a client doing vocal imitation sessions with the use of a vocal stimulation machine, a piece of equipment I have never come across in the United States. Apparently the client's grandmother suffered a stroke which impacted her speech, and when she began seeing a Physiotherapist (Kenyan lingo for Physical Therapist), she began using the machine. When use of the machine resulted in rehabilitation of her speech, the client's mother wished for her son to use the same machine. Since using the machine, Pooja and the parent report increases in vocal production and sounds, however variables have not been systematically manipulated to determine which intervention, or combination thereof, account for the increase in speech. I suggested perhaps we do an experimental analysis of behavior and embark on an alternating treatments research design and a component analysis in order to determine which variable(s) are responsible for the increase in speech. Given the machine is more of a speech language/physical therapy intervention, it would be interesting to see if data would justify continued "rent" payment for use of the machine. Moreover, the mother has been very pleased with results as of late and attributes them in part to use of the machine, so it would be poor practice at this time to simply stop using the machine if data may indicate it has been helpful.  Nevermind that the Global Autism Project never seeks to enter into a partnership and come into a country and immediately disrupt what the culture has viewed as successful if there is no data to substantiate our decisions. I'm excited to see what data will tell us!!


We also had the opportunity to meet with the mother of a 12 year old girl, and her "aya" (Swahili word for maid) to discuss targets for program development and skill acquisition. She is not in school, and has not been in school for sometime. The education system in Kenya does not seem to strictly oversee and mandate children being in school, which from what I've observed, and based on interviews with multiple families, teachers and professionals, this may not necessarily be all bad for special needs children if they are not getting the support they need by teachers who have an understanding and skillset fundamental to growth and progression. (This also happens to be a possible exciting venture for me in the future and on subsequent trips: a comparative analysis of how education and special education in Kenya compares to IDEA in the United States)  Her mother pulled her out of school due to lack of progression, and has increased her sessions at Kaizora with Pooja, since that is where she has seen the most growth and development.  I suggested perhaps we target some functional life skills training, such as cooking, cleaning, shopping, money management, etc.  The mother was thrilled, and would like to see her daughter develop some skills in these areas, especially since her aya can oversee many of these tasks.


I will be training Pooja and the Kaizora staff how to implement the Functional Independent Skills Assessment and work with Pooja to design programs to target areas of need based on lifestyle, traditions, and ways of life for her family and the culture of Kenyan people.  This is a task I am REALLY excited about, given that results may be seen not just in academic domains, but in self help and activities of daily living as well.  By continuously gauging and assessing not only progress based on follow-up assessments, but on parent satisfaction at home, we can ensure we are targeting skills that are proving to be most useful and beneficial.  So many exciting clinical developments today!!!


- Emily

Making Progress!

Another day started bright and early!

Today we have been at the centre for the whole day and managed brainstorming about the children and their programs and the direction we’d like to see things going which has been amazing. Emily has brought up some amazing points and provided lots of guidance on what direction we can take things next.

We met with Mary’s mum today who was has always been incredibly pleased with everything Melissa has accomplished to date that she never expected her to… but now even more thrilled knowing that there’s still so much more to come. In fact she was saying that she’d love to be a candidate for any research and participate in any possible way!

We also went through Max’s programs in detail, who is a fairly new student and broke down each program and the procedure we’re going to teach every single thing in. We did all this with Molly, Emily and myself over skype. It’s been really amazing as well how the 3 of us are talking even twice a day over skype and keeping updated on everything.

It’s been a really exciting day and I’m feeling more and more confident with everything we’re running here as the days are going by, and we’re only on day 3 so far yayyyy!! 

- Pooja

School Visit on Day 2!

Today we had a bright and early start and as Emily says, “we hit the floor running”!
We put up the poster which looks soooo amazing!! Then we planned on the 2 consultations with Johnny’s and Sammy’s parents/aids. We then went and visited a school for children with disabilities. School H is doing amazing things for the children with the resources they have. They are in a low SES area but still do so much, which is something I find very inspiring.

We then went to School S where some of the children who come to Kaizora also go. School S is a mainstream education school in a higher SES area. There we had a wonderful and productive consultation with Johnny’s teacher, teacher-to-be, mum, and the head teacher. We managed coming up with some great ideas and goals, and also provided various strategies they can implement in the school setting to promote social skills among others. We talked about what Johnny should be doing in his next school year and how we can use the holidays to get him at par with everything.

Back at Kaizora we then meet with Sammy’s aid and mum and talked over behaviour modification in the classroom. This also went great and mum sent a text saying “Hi, thank so much. The aid says it was really helpful. She has been on a 1 week training in 2005 & no one has ever come to school to talk to the assistants like you have today”! We will be providing data sheets to help identify the ABC in Sammy’s behaviours in school, and hopefully having such a system in place will shed light on plenty more.
The consultation after that with Johnny’s mum went fabulous as well and we identified lots of goals and went over his progress so far. She was very happy with all the information, and some of the things we plan on doing while Emily is here is weaning him off his GFCF diet!

Overall, the day has been absolutely amazing, and I’m so excited for the next 2 weeks as well… everyday is a new learning experience! 
-Pooja

Day 2!

Today was a very humbling day, as I had the opportunity to see two very different special needs schools serving very different populations and demographics.  The first very small school was located in one of the lowest socioeconomic areas of Nairobi, where many students had physical and mental disabilities that were the result of malaria, HIV/AIDS, cholera and malnutrition.  School fees equate to US$2/month, and children are provided with environmental arrangements based on principles of behavioral prompting and cueing, occupational therapy, physical therapy, speech therapy, medical assistance including HIV testing and proper nutrition.  Upon speaking with one of the teachers at great length about service delivery and needs, she indicated that one of the biggest barriers was overall awareness of disabilities, and alleviating the stigma associated with having a child with a disability.  Slowly as awareness increases, more mothers are coming out of the woodwork to seek assistance with their children.  This has implications for targeting awareness across the country in general in order to encourage those that having a child with a disability is a reality that cannot be avoided or always hidden, but there are ways to support families and creating measurable, observable behavioral change to increase overall functioning in everyday life.  On the other side of the spectrum, we visited a mainstream Pre-K and K school where school fees were approximately US$1000/4 months.  In this case, awareness of disabilities were more openly embraced and provided for accordingly.  Parents were able to see successes overtime with their special needs children, and were satisfied with results.  Collaboration with Kaizora Center also facilitated consistent skill acquisition both at school and at home, resulting in parents acknowledging the extra behavioral support needed at times.  Both parents and school staff were able to attest to the gains children had made when combining school-based learning with ABA therapy provided at Kaizora Center.  At the end of the day, after familiarizing myself with two different settings serving children in Nairobi, what seems clear is that when awareness of special needs children is embraced by families and care providers, appropriate interventions and assistance is sought.  And when those reach out for assistance, and are provided with ABA therapy and methodologies spanning a variety of contexts, families are extremely satisfied with overall independent levels of functioning both at home and at school, as well as functioning amongst the dynamics of the family unit.  This in and of itself may indicate that demonstrating measurable, behavioral change may increase the likelihood that services can be provided to more individuals in more places.  This seems like an ideal starting point and initiative for Global Autism Project and Kaizora Center.    

- Emily

Emily arrived!

Emilyy got here today yayy :)
We got to show her the centre briefly and talk over lots of stuff… and then the day ended too soon! It’s really exciting though, we’re super thrilled that she’s here! Most of all, through all our conversations, it’s extremely reassuring to hear her response on various issues and know that we’re on the right path! 

- Pooja

Back to School

As the air cools and leaves begin to change their color in the US, the sun begins to burn brighter here in Ghana. Similar to the US, September not only begins a change in weather, it also signifies the reopening of a new school year. During the summer months, AACT had about 15 students who regularly attended the center with just about one caregiver for every child. Many of the other students traveled with their families or stayed home with other siblings on vacation. Over the past few weeks, all of these students have returned. Now a typical day at AACT has about 25 students, being taught by 12 caregivers, 3 directors, and a few volunteers. Not including the daily visitors, there are over 40 moving bodies in the center on a regular basis, at least half of whom have autism.



Due to increased attendance, it became necessary to find more effective ways to keep groups of students engaged. With support from Auntie Baaba and help from two new volunteers, we put together a more structured morning routine for the middle classroom. We choose this room to focus on first, because they typically have the most students with the least amount of caregivers. The routine involves the students identifying “who is here today” by moving pictures of themselves to the appropriate area, going through the day of the week, month, year, and then identifying the weather. So far, it seems to be working well!



There has been a lot of other excitement over the past few weeks. On September 8th, a television series called Impact Africa came to film an episode at AACT. This included footage of the students activities and interviews with Auntie Serwah and I. Last week, the Rotary Club came to present a donation to the center. There were over 25 members who came for the ceremony. It was a great opportunity for them to learn more about children with autism and the services provided at AACT.



On top of all of this, I have been continuing correspondence with a variety of others. Caroline Pongo, the creator of a local educational puppet theater, came to the center last Thursday. Her and I discussed getting the students involved with a puppet making workshop, as well as planning a performance at the center. Stacey Reynolds, an Occupational Therapy professor at Virginia Commonwealth University has agreed to include AACT on their annual service trip next May. This is especially exciting because there are currently no Occupational Therapists in Ghana. This coming Monday, I have a meeting with Nana Ocran, the Director of Education at the Ghana National Museum, to begin setting up educational programs at the museum modified for children with autism.

In regards to administrative tasks, I have been involved with developing job descriptions and creating an employee code of conduct. These will be compiled into an employee handbook and be available in the future for new employees. As volunteers come and go, we have been asking for their feedback as well, in order to continuously improve the current volunteer handbook. The point of all of this is documentation. Keeping records, putting job rules and regulations on paper, tracking the number of volunteers in a given time period, etc. It all helps to strengthen an organization’s permanence.


Last but not least, the Caregiver Challenge, a fundraiser started about a week and a half ago, has already raise 130GHc (about equal to about $90 US Dollars)! Auntie Serwah has created a bank account that is specifically for donations. The goal is to not touch this money until there is enough to build, buy, or rent an additional, desperately needed, facility.

All in all, things are progressing! And as much as I miss the beautiful fall weather, the warm sun doesn’t feel too bad. Thanks again for reading.

Until next time,
Casey

Saturday August 1, '09

Last weekend Lori, Brad and Alicia all flew back to the US. It was sad to see them go, but know they accomplished an incredible amount over the course of their three weeks in Ghana.

Work started with the development and implementation of preference assessments. These will be used to determine potential reinforcers for communication opportunities and academic work. In collaboration with Baaba, we helped to create an afternoon activity schedule. This not only gives the students more structure, it also puts selected staff in leadership positions, increasing overall accountability.

Throughout the trip, Lori and Brad put together workshops for the staff. These included trainings on the Picture Exchange Communication System (PECS), Pivotal Response Treatment (PRT), and Functional Behavior Assessments. Along with the workshops, we all helped to make the necessary PECS pictures cards and provided consultation on their use. The BI Capture was also set up. The AACT staff was taught how to use it when evaluating problem behavior or modeling effective techniques.

Last, but certainly not least, Alicia built four specially modified workstations. The materials used were all locally acquired, in order for more of them to be created by AACT staff in the future. Needless to say, Lori, Brad and Alicia were fantastic on many levels. They will certainly be missed here in Ghana.

As for the past week...

Baaba came into work Monday morning with a mission to clean. Every day we choose one room or space to tackle. Broken, chewed, unuseful toys were thrown away. Selected toys and teaching tools, including all stuffed animals, were washed. Once inventory was taken, we were able to make every child there own set of supplies. Each pouch included a new box of crayons, colored pencils, a pen, a pencil, sharpener, and eraser. The individual classrooms were also given the appropriate toys and teaching materials according to the needs of the students.

Once again, a personal thank you to Lori, Brad and Alicia for being excellent volunteers. Can't wait to work with you again next summer in India!

Going now to enjoy some delicious grilled plantain.
Casey

Friday, July 24

Greetings!

This is Lori again. We had a very exciting day today at the centre! In the morning Brad helped the centre with evaluating a new potential student. I went with the Casey to print out all of our training summaries as well as the graph showing the number of functional communication statements made by students during snack before we started training and after we started training. The data was very impressive! Casey will be taking data a week or so after we leave so we can measure if this change in staff behavior (increased opportunities for communication) is maintained. Considering the enthusiasm by the staff over the impact this has had on the students, I believe that this change will be maintained after we are gone.

In the afternoon, Brad and I did our third Functional Behavior Assessment (FBA) workshop with the staff. The response from the staff was amazing! In all three workshops the staff had excellent questions and were really beginning to understand the functions of behavior. After one of the workshops, two staff members came up to Brad and I to tell us this was the best training they had received in five years working with kids with Autism. They told us that often times people in the community turn to them for answers about what is Autism and how can Autism be treated and they are often unsure of the answer. They said the workshops from this training trip helped them understand Autism and Applied Behavior Analysis so that they could answer the questions of people in their community. One of the staff members even told us that every day since the beginning of our visit she has gone home and shared with her family what she had learned from us that day. All of the comments from the workshops were incredibly powerful, but these in particular were very touching and meaningful to us. It is such an honor to be able to provide knowledge and information to individuals who are so dedicated to their work and hungry to learn more.

During the FBA workshops we also showed the staff how to use the BI Capture. In the morning, the staff set up the BI Capture (with a little guidance from us) and used the BI Capture to get videos of a student’s biting behavior. The supervisor at the centre will review these videos with the staff to determine the function of the behavior and be able to come up with an effective intervention plan.

Alicia finished modifying the desks today! They look absolutely amazing and are the best desks I have seen for Autism intervention. The pull-out drawer leaves space for data taking and lesson plans without placing too much onto the desktop. The beads make data collection easy which allows for faster teaching. There is even a spot on the desk where the reinforcer is placed so that staff does not forget to determine what the child will be working for before beginning teaching. The staff was very excited about these new desks and we look forward to their feedback as they begin using them.

After our day at the centre, Brad and I had a drum workshop with a local drummer. This was a truly remarkable experience! We sat in his drum workshop (where you can watch cattle passing by) and played our African drums together! Then we had a traditional ceremony where liquor is poured on the floor (and a little on the drums) as a blessing. I have to say, I have never had an experience quite like it!

Alicia and Casey went to the market and then met us for dinner at the vegan restaurant (again) where we had some delicious veggie stir fry, pasta and yam fries. I am very sad to say goodbye! I look forward to keeping in touch with the staff at the centre as many of them want to continue to learn more about Autism and ABA. I cannot express how meaningful this trip has been to me. Being able to see an Autism centre in another part of the world and collaborate with the staff there has been a great pleasure and wonderful learning experience.

As always, thanks for reading! I look forward to sharing future trips with you!

Afua (this is my Ghanian name!)

Day 8: July 14

Greetings from Brad,

We had another busy day at the centre, working with the staff to develop and implement a preference assessment for all of the students. The preference assessment will be used to gain some insight into what motivates each student. We will then use these "motivators" as reinforces for appropriate communication and academic demands.

Lori and I also continued with the PECS and PRT trainings that we had started on Monday. The staff responded amazingly, jumping into the demonstration and showing that these skills are like many that they are already using. We are confident that the staff will be able to apply these approaches to their interactions with the students.

Alicia continues to make progress with her project by having completed all of the sanding. In addition, she started painting (with a color scheme of grey for the legs and blue for the tops) the desks.

After handing out the certificates of achievement to the local staff we headed back to our village to prepare for our personally cooked meal. Before the meal we worked up an appetite by taking a walk to Independence Square. We took in all of the sights, the memorial arch and the conference centre, which are really stunning. Back to the meal, through a mutual friend we had an amazing typical Ghanaian meal that consisted of a pasta with seasonings, jolof rice (similar to spanish rice), and a salad of cabbage, potatoes, and salad cream. This was all topped off with an amazing orange crepe dessert that I hear was incredibly delicious (there was no vegan option, so I had more jolof).

Tomorrow we are heading out on an excursion to the botanical gardens. Lewis, the official drummer of the Global Autism Project will be joining us to provide a drumming workshop for the students. This is going to be great!

Respect,

brad "kofi" herron

They are SO stellar!

Today it was a back to work at the Centre...We got an early start trying to set up the BI Capture and preparing for the second training on the Picture Exchange Communication System...The support team has been incredible..AACT and the Global Autism Project are really working together to get this BI Capture software up and running. The staff did very well with what they have done so far, so we took the next step by showing them how to take data on this system. Everyone was enthusiastic about a way to track progress and was eager to practice data collection. The participation was wonderful...More of the staff were able to practice and they were all excited to see the system in action. After a quick review of discrete trials it was back to the classroom for some assistance with behavior management. This incredibly dedicated staff are always ready to help these children and we can see how our support has been helpful to them. What an honor to work with these amazing people. Medasi pa, AACT! ("Thank you very much" in Twi).



After the morning of work at the Centre, we were inteviewed for our new video describing our work with the project. This video is a great tool to raise awareness of childen with autism in other parts of the world. Look for it on our website in the coming months!

And now it's another evening at good ol' Busy Internet creating materials, and, of course, blogging.

It's hard to believe that tomorrow will be our last full day at the Centre. It should be a full one, starting off with data share with Mr. Mawusi in the morning and finishing up who knows when!

Stellar students!

Today was another hectic day in Ghana...we are really making the most of our brief visit. We got an early start at the Centre. After working long into the night on our presentation, we got an early start at the Centre. Thankfully, Molly and Mawusi noticed that the rain was coming and moved the presentation indoors so Ann didn't get drenched! Before the presentation, Molly was able to speak to an aunt who had come to inquire about services for her nephew, who is 13 years old and without services. This woman had the same questions that many family members have in the states. What is the cause? Will he make progress? It was a powerful reminder that, even across the ocean, our concerns are more alike than they are different.

The presentation on PECS (the Picture Exchange Communication System) went beautifully. Ann gave examples of how to teach a child to use pictures to communicate. Mawusi was helping by playing the role of both teacher and child in the demonstrations. The staff was eager to see the system used with one of the children, and we were all delighted when she was able to exchange the pictures to request so quickly. The entire room burst into applause (including the trainers!). Some staff members tried the system and when the child's aunt picked her up at the end of the day, she was excited to try it at home too!

We also reviewed with Mawusi some of the data that had been taken on the children's programs. It was amazing to see their enthusiasm for this new system. We are all getting excited about the possibility of going to the Association of Behavior Analysis conference in Norway in 2009. Ann and Molly would be particularly happy to see Mawusi there -- he speaks Norwegian! How will we manage without him?

We headed down to the Cultural Arts Centre to look for gifts for our supporters in New York and then at dinner met an American couple who had also started a nonprofit working in rural areas. Even she said, "I didn't know there was autism in Ghana". It's good to know that we can make an impact raising awareness of the need for services in Ghana both here in Ghana and abroad

Well, for tonight it's back to the house for another meeting with Nic and maybe a full night's sleep...but knowing us, maybe not!