Wow, is it really the 1st of March? For how slow some things tend to be here in Ghana, my time always goes so quickly!

Friday, the 6 of February was supposed to be the first day of caregiver training at AACT. Even after communicating via email with both Auntie Serwah and Auntie Baaba throughout the week about the training details, there was still a conflict. Upon arrival to AACT, I learned that Auntie Serwah had actually planned to throw herself a belated birthday party. This included music, food and drinks for the entire school day. While it was fun and a kind gesture, it did not create the most effective environment for teaching. Due to this circumstance, the training was rescheduled for the following weeks.

I left AACT that day feeling frustrasted. Frustrated at the lack of communication between administration and volunteers, as well as the lack of attention being given to the students. It was then that it hit me. So many volunteers have come through AACT to do caregivers trainings. So many volunteers have addressed these issues in lecture style classes. Although all of them have some level of positive outcome, the real net gain is small. How do we change this?! It is clear from the long range effect, or lack there of, that these type of teaching may not be the best way to reach everyone. Therefore we, the teachers, must change our teaching style in order to accommodate our “students.”

Instead of a lecture that following Friday we played charades. For anyone who is not familiar, this is a game where you have to act out a specific event, character, or action without using any spoken language. Then your team mates have to guess what you are trying to convey. Not knowing how this was going to turn out, I made about 20 different cards, divided the teams and crossed my fingers. After the first few warm-ups, the caregivers were into it! Not only were they cheering for their teams, they were actually acting with expression.



Once the game was over. The question was posed: “What was the purpose of playing?” Silence. So adapting my question, I asked them to how it felt when their respective teams were unable to guess what the actor was trying to portray. “It was frustrating,” “it was annoying,” “it made them mad not being able to verbally communicate a message.” Exactly.


The majority of the students at AACT have not developed verbal communication skills, nor have they learned any other form of effective communication. It is my hope that the caregivers now have a better understanding of how these children feel everyday of their lives. If nothing else though, the game has now been carried out to an unexpected level. Since that Friday, one specific caregiver has taken it upon himself to set up the game every week. After our lessons, he has run a charades game. Last week he even brought prizes for both the team who won and the team who lost!

Besides charades, there are a few new items to report. First of all, I want to say how proud I am of the caregivers and Auntie Baaba for initiating the use of PECS during their lunch time. Right before the holiday break Auntie Baaba made some pictures of pure water bags, spoons and forks. At first, I was unsure about how effective it was going to be just due to the inconsistency of their use. Although, to my amazement, the caregivers have gotten quite good with this system and the children have really responded. The majority of students will now request these items either verbally or with the pictures! Its a great step towards teaching communication that now needs to be expanded.


Auntie Baaba and Auntie Serwah also decided to change around the classrooms. Where the older students were is now where the primary class is and visa versa. This makes so much difference. It is much less distracting for the young ones and also gives them more space, with direct access to the bathrooms and kitchen.


Planning for Autism Awareness Month is also progressing! The following are the tentative dates and events planned as of last Friday, February 26th with Auntie Baaba and Auntie Serwah:

17th – 19th March - Autism Awareness Table at Accra Mall with Joyful Way Inc.

20th March - Mandatory AACT Parent's Meeting

28th March - Autism Awareness Concert at the National Theater Hosted by Joyful Way Inc.

1st April - Press Conference

2nd April- World Autism Awareness Day

9th April - AACT Community Awareness Walk

17th April - Informational Seminar at British Council

22nd April - Benefit Concert in Osu

24th April - All Parents of Children with Autism Meeting at Multikids

Its going to be a wild month of events!

As always, thank you for reading.
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

Day 15: July 21, 2009

Greetings and salutations,

Today was another day jam packed with work and steady progress. Alicia is nearly finished with her desk project; when finished the centre will have four retrofitted desks at their disposal. The new design of these desks will make instruction and data collection more effective and efficient.
I spent my morning working with a staff member to review, revise, and develop a number of new training and assessment documents. These documents included a PECS and PRT procedure poster for each of the classrooms, an A-B-C chart for use with functional behavior assessments, and a brand new preference assessment worksheet. This collaboration was an excellent example of how the Global Autism Project works to empower existing resources within the centre. Lori, a staff member, and I spent the afternoon conducting a workshop on functional behavior assessments. Again, it was great to work side by side with staff member who had so much knowledge and experience to share with the staff and us.
Casey spent her morning drafting an AACT volunteer questionnaire; this document will be used in the continuous refinement of volunteer roles, duties, expectations, etc. Casey’s afternoon was split across training a staff member in PECS and helping to facilitate the newly created afternoon structured play activities. While giving the staff and students something new to do, these activities aim to provide staff and students with continued opportunities to utilize PECS and PRT.
Our evening was filled with a quick trip to the National Cultural Centre (place where all the souvenirs are sold) where the girls picked up some last minute gifts: wooden spoons, a wooden boar (which was actually a rhino), and jewelry. After this, we had another delicious catered dinner courtesy of a friend of the project. We were joined by a number of volunteers that are also working with the centre.
Tomorrow we will continue to focus on finishing up our works in progress…
Thanks for reading.

Respect,

brad herron

Day 14: Monday July 20, 2009

Hello beloved readers!

Today was a wonderful day at the centre! Alicia got a first coat of paint on ALL of the desks and chairs that she is working on modifying (they will be set up to create a more efficient way for the teachers to take data while teaching). They look amazing!

We have found another project for Alicia (like she was not busy enough!). We will hopefully be modifying another desk to become a wheeling cart that will hold the BI Capture. This way the staff can wheel the BI Capture wherever it needs to be! Alicia made a trip to the hardware store but as of now the wheels have not been found. We hope for more success in the future!
Brad, Casey and I tackled the task of getting the BI Capture up, running and in use today. I am happy to report it was a success! We were able to teach a staff member at the centre how to record videos of any problematic behaviors during his teaching session. He did a phenomenal job both getting the videos and teaching! We will use the videos taken today for the Functional Behavior Assessment (FBA) workshops that will happen on Tuesday and Wednesday afternoon this week. During these workshops we will also teach the staff how to use the BI Capture to improve teaching and determine the function of problematic behaviors.

At snack time today I was overjoyed to see the staff members setting up language opportunities for the students (what we worked on in the workshops last week). In the preschool classroom, one teacher had all the snacks and each child needed to request the snack (either with a picture card or verbally) before receiving it. In the other two classrooms each staff member set up repeated language opportunities for the student he/she was working with. It is incredible to see the increase in spontaneous communication for these students in only a week!
We also worked together with the staff (and some students) to make more PECS picture cards. We used a list generated by the staff of all the preferred items/activities for the students using PECS and made all of the picture cards requested. The staff will be putting together communication books for each student who will be using PECS and there will also be picture cards located in different areas of the school so staff will be able to easily set up language opportunities throughout the school day.

On Thursday we will be presenting to a group of local doctors (thanks to Casey!) on Autism Spectrum Disorders (ASD). We are very excited about this opportunity to continue to increase awareness and knowledge of ASD in Ghana, especially within the medical community.
After a productive and exhilarating day at the centre, Casey, Alicia, Brad and I traveled to circle market where we did some fabric shopping on the way to our tro tro. We had an excellent meal at our local vegan restaurant and ended the day by relaxing on our patio listening to the waves.

Looking forward to another great day at the centre tomorrow!

Thanks for reading!

Lori

Day 9: Wednesday July 15, 2009

Salutations from Accra!

This is Lori. We had a truly amazing Wednesday! It was excursion day at AACT; so we all packed into a bus and traveled to the University of Lagion’s Botanical Gardens. The children were wonderful on the bus ride, although traffic was occasionally a challenge. We arrived to the botanical gardens where we were given a tour of the grounds. We enjoyed a boat ride in a small lagoon (well, Alicia enjoyed it while Brad and I paddled the boat). We also went with the children and staff at AACT to see various farm animals including goats and chickens. Some of the children enjoyed chasing the chickens.

At the botanical gardens there was an amazing playground. The children (and adults) enjoyed a fantastic seesaw that went up high and could spin around (I enjoyed trying it out!). There were other seesaws, slides, swings, and cars that the children could peddle. Everyone enjoyed playing for hours! I also witnessed several staff members creating communication opportunities during mealtime and on the playground (something we discussed in our workshops earlier this week).
Lewis, a local drummer who volunteers time at the centre, played drums for the children both at the centre before we left for the field trip and at the botanical gardens. He even played on the bus ride home. It felt like a party bus as music was played and staff and children were dancing and clapping the entire ride home.

Brad and I recently finished our first staff workshops on teaching communication using PECS and Pivotal Response Treatments (PRT). I was overwhelmed by the quality of questions and comments the staff had during this workshop. I also enjoyed one of the most interesting conversations I have ever had on perceptions of autism in various communities and the challenges of working with individuals with of autism. I found it very interesting that the challenges the staff mentioned at AACT are very similar to challenges I have faced working at various centers in the US. Some of the challenges they mentioned were raising awareness about autism within the community so that families would be able to bring their children into the community without fear of judgment. They also mentioned that training parents and making sure that intervention is consistent across home and school is often a challenge. Selected the best intervention and teaching methods for each child is another challenge they mentioned.
This trip has been an incredible learning experience for me as I have now been able to see that autism is the same in other parts of the world and that individuals who dedicate their time to improve the lives of individuals with autism often face similar challenges all over the world.
After our excursion we enjoyed some more delicious Italian food at a local restaurant called Mamma Mia. We then visited a sky lounge that overlooks the city. It looked like any place you would visit in the US. There are many times that I will be in a place such as a restaurant or a lounge here and forget where I am so much so that I am surprised when I step outside to see the large street gutters and vendors walking by. AACT is one of those places. I often forget that I am in a developing country as I feel like this centre could be anywhere in the US. They are individuals who are dedicated to research based interventions for children with autism in a place where it often perceived that the cause of autism is an evil spirit possessing the individual.

Tomorrow we will be visiting a place called Cape Coast!

Thanks for reading!
Lori

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

Day 4: Friday, July 10th

Friday July 10, 2009
Happy Friday from Africa!

This is Lori again. We had an amazing day at the Centre. Alicia returned to the hardware store (she just cannot get enough of that place!). Her construction continues to amaze the rest of us. She is a talented engineer and carpenter.

Molly and I brainstormed with the wonderful administrators at the Centre to create a new daily schedule that would maximize learning time. A new afternoon schedule was developed where, rather than free play, different structured activities (3 to be exact) would be available to students to participate in. By adding structure and choices, this will increase student’s engagement in appropriate activities (and also create more communication opportunities). Staff members would be assigned to a specific activity for the day. These activities would change daily.

Brad and I worked with the staff on creating language opportunities during motivating activities (such as snack). Some of the students are using the Picture Exchange Communication System (PECS) to communicate, while others are using verbalizations to communicate. For students using vocals we are teaching the staff to use Pivotal Response Treatments (PRT) to work on social communication. The staff’s previous training in PECS was apparent by their strong teaching skills.

Brad and I also outlined our staff trainings for the visit. We will provide teaching sessions that will include demonstrations of skills with students and practice by staff members. These trainings will focus on PECS, PRT, functional behavior assessments (FBA), functional communication training (FCT), and addressing problem behavior.

Molly worked closely with Baaba, the phenomenal Administrator of AACT to begin to create a volunteer training orientation program. AACT is very fortunate to receive volunteers interested in joining them from all over the world through various organizations. Baaba said she was looking forward to implementing a strong and organized volunteer orientation program, complete with social outings for volunteers and AACT staff to get to know each other!

After our visit at AACT, we took an adventure to Kokrobite Beach (about 30 minutes west of Accra). There we made a vegan dinner from local vegetables with the assistance of friends from the area. In the evening, we were the guests of honor at a bonfire on the beach with African drumming and dancing. Molly, Brad and I participated in the festivities while Alicia was our photographer of the amazingly beautiful event. It was a truly remarkable experience!
Thanks for reading!
Lori

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!