N.L.P and the MOVE programme

© Lesley Ashworth

These observations were undertaken over a period of nine months in a classroom provided for students with intellectual and physical disabilities especially those diagnosed autistic. It began with a discussion on the challenging behaviours which were arising in the class room and the frustration of the staff at not being able to help the students progress in either their educational or physical development. Having just completed my N.L.P Practitioner’s course I was interested to see if I could use my newfound curiosity to develop a means to help resolve these difficulties. At the same time the classroom teacher, Wendy was undertaking courses for Movement Opportunities Via Education (MOVE).

MOVE

Movement Opportunities Via Education or MOVE for short is a programme for life. It concentrates on functional movement and focuses on the student’s needs and the student becoming independent in their movement. It comprises of three areas. Sitting, standing, and walking. It asks the parents what their dreams are for their child then asks them to imagine what it would be like if that happened. The programme then analyses the skills that the student has already and then focuses on developing the skills that are going to be needed for them to reach these goals. MOVE programme places the students in a position where they will experience less support in the above-mentioned areas. The support reduces as the functioning ability in these areas increases.

I observed the students over a number of days. After looking at the information gained and having looked for any documented research in this area I became aware that much of what I could do was act on the basis that there was no such thing as coincidence and that we would need to take this information at face value.

The Students.

To protect the privacy of the students I will use a letter in place of a name. The students had very individualised blocks to learning. They are described here using terminology that will make sense to NLP Practitioners.

L aged 9

How were the difficulties in learning being created?

L had an over extension of his spine meaning that his head and neck were always extended in a backward arch. He was virtually unaware of what was happening around him. He hardly ever engaged in any meaningful interaction. L was constantly in a visual trance.

N.L.P description

I observed L over a number of days concentrating mainly on his eye accessing cues.

L spent most of his time accessing visual. He had very few eye movements to other areas except for appearing to run a visual kinaesthetic loop, which always resulted in him engaging in inappropriate excessive laughter. L did not appear to have any skills to prevent this.

Actions taken for L

1. We used a collar to gently bring L’s head into a natural head spine alignment, and make it easier for him to access all sensory areas.
2. We practised accessing all the sensory areas by getting him to track with his eyes a favourite visual toy. This encouraged him to circle his eyes through each sensory area in turn. When he hesitated or lost the focus of the toy we re-traced the circle until he focused on the toy again and then continued.
3. We used other visual stimuli to pace and lead him into other sensory areas. In each area an activity would happen related to the processing of that area.
4. E.g. music would be played whilst he was in auditory. Food would start in visual, eye track down to kinaesthetic and then be eaten.
5. Visual was also used to develop cause and effect communication skills, as it was his most highly motivating area at that time. In order for a light to flash he needed to tap a switch machine very gently. This was initially carried out by moving his hand on to a switch and showing him a cause and effect action and then encouraging him to do it himself.
6. Visual motivation was also used to encourage L to walk in a walking frame.  He could choose to follow a favourite toy, reach out for it and then have time interacting with it and the teacher.

MOVE description L

Sitting: Hips, back and arms needed to be fully supported

Walking: No walking position and no walking movement. The arch in his spine was too strong to support position.

Standing: Had pulled himself up to standing on rare occasions (1-2 times a month) but couldn’t get back down.

Student description at present.

L is now sitting independently on an ordinary chair in real terms this means he can sit like the rest of his family at meal times.

L is now comfortable independently walking around using a rifton pacer. In real life terms this means that he can walk if supported under his arms either from the front or the back he is able to move one leg in front of the other himself.

L will now stand for at least 3 min for example he can pull himself up to the piano and press the keys he is then able to lower himself back down to the ground. His feet are also flat on the floor.

L constantly interacts through play, laughing and even having small fights with J over a shaker made out of a dish washing liquid bottle, or other toys. He is able to use a switch; he is inquisitive, aware and interested in what is going on around him. L is also able to crawl now with virtually no arch to his back and with out the collar.

J aged 9

How were the difficulties in learning being created? J would spend a vast amount of time rocking, making very small repetitive movements and holding things in his mouth. He would become very distressed and would begin to scream and sometimes engage in hitting himself. He virtually never engaged in interactive play and was very unaware of the activity of people around him.

N.L.P description

J would start to make small noises and start to rock, the noises becoming louder and the rocking more intense and repetitive. He appeared to become overloaded whilst processing in the kinaesthetic area of his brain. It was commented on more than one occasion that he was winding himself up. When I observed him it was apparent that he was running an Ad K loop, which eventually settled in K when he was displaying distressed behaviours. He demonstrated no skills to exit this state.

J responded to auditory stimuli.

Actions taken for J.

1. We used musical instruments to lead J through all the sensory areas, eye tracking in a large circle, concentrating on visual, as he seemed calmest in this area.
2. We used an auditory pattern break. Whenever J appeared to be spiralling down we rattled the maracas and led his eyes up to visual recall.
3. On one occasion he was near the piano when this happened the teacher played a note and J being below the level of the piano had to look upwards. This worked instantly and was a repeatable strategy.
4. We used auditory stimuli to pace and lead him into the appropriate sensory area for particular activities.
5. We used auditory stimulation to develop cause and effect communication by switching a switch to activate a noise.

MOVE description J

Sitting: Could sit on the floor unaided.

Standing: Could tolerate a small amount of weight bearing through his legs.

Walking: No motivation to walk virtually no walking action.

Student description at present.

J can move around the room whilst in a sitting position. He is able to sit at the table in a chair and take part in family meals can now walk at least 100 metres with somebody supporting his hands either from the back or the front. He just loves to walk from his taxi into the class or to the sand pit in the playground. J now seeks interaction with other people. He uses a switch confidently, is inquisitive and as the staff say ‘ into everything’. J can be stood to change and sits on the toilet.  He laughs in appropriate situations and loves rough and tumble tickling games. J ‘s latest trick is to climb up on furniture and scare the daylights out of the staff. Last week J lifted his foot to take his first unaided un- supported step. Next time he does it he will complete the step.

S aged 12

How were the difficulties in learning being created? S appeared to have very little awareness of her environment. She would have a small number of positive reactions to things and would spend a lot of time staring at the room in general and showing few signs of really focusing in on anything in particular. S’s motivation to engage in any activity, which involved interaction or physical contact, was very low. S spent a large proportion of the day sleeping or cat napping loud noises or fast movements startled her greatly.

All these students are non -verbal and show little comprehension of language.

N.L.P description

S spent much of her time in visual either construct or recall.

 Actions taken for S

1. We discovered that if S was stimulated by bringing her into Kinaesthetic and keeping her there for a couple of minutes she became far more aware and responded to her environment in a more interactive way.
2. We set up a programme where before every activity her arms were massaged we then used visual stimulation to encourage her to use switches.
3. S found any movement distressing so during the MOVE activities she would become quite distressed. Whilst she was engaging in a physical activity such as walking in her rifton walker we also massaged her head gently, paced her vocally and then she was more comfortable and aware in this way more progress was made. The activity also appeared to be a far more enjoyable one for her.

MOVE description S

Sitting: Fully supported in a wheel chair in a reclining position.

Standing: Could tolerate standing in a fully supported standing frame for a short amount of time.

Walking: No walking

Student description at present.

S is now able to sit in a supported chair with no shoulder support and no side support whilst sitting fully upright. She is able to hold her head upright for two minutes as opposed to 5 seconds previously.

S is standing now for up to 3 minutes with leg braces and full body support (adult standing behind holding her arms and supporting her body). She is assisted to walk in a rifton pacer has good head control during this time and is enjoying it more and more. She demonstrates this with happier facial expression, a more relaxed body posture and looking around. S is more aware of her environment and the people in it. She makes more eye contact and looks around to see what is happening. At circle time when the other students are introducing themselves she will follow their progress with her eyes waiting until they get to her.

Staff Training

When I first talked to the staff at this unit they were encountering a number of difficulties both in motivational terms and in terms of organisation and time.

 Class teacher. ‘It was tedious doing same things day in and day out and seeing no progress’.

The staff were disillusioned at the possibility of the students not being able to make much progress and had no feeling of what they could do next.

I implemented some training on eye accessing cues and what it meant. We explored how that student processed external information. We also looked at having positive fun anchors for activities and anchors for changing activity.

The classroom is now far more positive and rewarding and the staff can see the changes occurring in front of them.

Class teacher. ‘ N.L.P gave a key to understanding how the students were processing the world. It gave the staff skills to understand the challenging behaviours of the students, to initially control the behaviours and then teach the students the skills necessary to change their own behaviours.’

I thoroughly enjoyed being part of this change process. I am in awe of the changes these students a have made over the past few months and the simplicity of the techniques we used.

• Lesley Ashworth.