An Early Start for Your Child with Autism: Using Everyday Activities to Help Kids Connect, Communicate, and Learn

by Rogers, Sally J.

  Describing your child’s play without interrupting or changing your child’s focus can help to maintain your child’s attention to you and the activity while you provide opportunities for learning language. Remember to position yourself in front of your child in such a way that your child can have a very clear view of your face. It helps your child to be more aware of your attention and your speech.

  Activity: Offer Help

  Another way to increase your child’s attention and engagement as you watch and narrate is to offer help. Hand your child toys during play or changing and bathing times after your child indicates an interest, rather than simply placing them within the child’s reach. Name them as you give them. Hand over bits of food one by one, rather than putting all the food on the high chair tray during meals, while you are seated in front of your child and narrating what’s happening. When your child reaches for an item slightly out of reach, say, “You want banana? Here’s the banana,” and hand it to your child. Or you can divide something into several pieces (like breaking a cookie into bits or handing over one block at a time). Using more pieces means more learning opportunities for your child to communicate with you and take in the words you say and the actions you do. Assist your child when he is struggling to reach a goal (like trying to stack a block), and make sure that your help is obvious to your child. Being the deliverer of desired objects and needed help makes you a part of the activity and helps your child attend to you and your language. Have the desired object ready, waiting and in plain sight, and deliver the object dramatically to be sure your child attends to you as you join in.

  “My child never needs help!” Some children are so determinedly independent that they never seem to need help. If you have a child like this, you will have to engineer some situations in which your child needs your help. You can create a situation in which your child needs your help by sometimes putting a favorite toy or food item in a clear plastic baggie or a jar with a lid, so that your child can see and touch the bag or jar but cannot open it. Then you can offer help by extending your hand and asking if your child needs help, opening the bag or jar, and giving the child the desired object. When your child recognizes the object in the bag or jar, he may indicate interest in getting it and may look from the bag or jar to you and back, or make a sound while looking at it, or pat it with his hands, or hand it to you. Even if you’re unsure whether your child wants the item inside the bag or jar, you can open it and give him the object. As you repeat this game over time with a few different materials, a game may develop.

  You can also offer enticing toys with special effects that the child needs your help to produce, such as winding up a toy that spins.

  Activity: Imitate Your

  Child’s Actions

  Another way of increasing attention to you and creating interactions is to imitate or mirror your child. While facing your child, play with the same toy or object, taking turns—or use a second identical toy or object to imitate her actions, so you don’t have to take the toy away from your child. For example, if your child begins to roll a car back and forth, you might use a second car to roll back and forth, imitating the speed with which your child is rolling the car. Imitation can also extend to noises or verbalizations your child might produce. Positioning yourself in front of your child and imitating her will almost certainly attract your child’s attention. If your child is trying to put a block in a box, hand blocks over one by one (helping), and also put some in yourself (imitating). If your child is banging a spoon on the high chair tray, get another spoon and bang in rhythm in front of your child, while saying, “Bang, bang, bang” (narrating). You are very likely to see your child’s attention come your way. This strategy of imitating your child’s play helps to shift her attention and builds awareness of you as a social partner. By joining your child’s ongoing activity and narrating as you go, you are turning a solo into a duet.

  Final Activity: Mix It Up—Combine Listening, Narrating, Helping,

  and Imitating

  We have just discussed four techniques for following your child’s interests and activities: active listening, narrating, helping, and imitating. These four techniques typically occur together when people play with very young children. Even though you have been focusing on one or another of the techniques as you were practicing them, you have probably found that you often used more than one at a time. Now that you’ve practiced each of these during your play and caregiving activities, take some time to practice following your child in many of your activities during the day. Do this with as many of the six types of activities listed earlier under Step 1 (page 66)—toy or other object play, social play, meals, caregiving (dressing/changing/bathing/bedtime), book activities, and household chores—as you can over the next few days.

  You will probably have to make a conscious decision to practice during an activity (though this will become more and more automatic for you as you practice and see the results). You will get an activity going or join your child in an already-begun activity, and once you are positioned well, consciously begin to follow your child. Spend about 5 minutes in the activity, and at the end, take a few minutes to think about when you listened and narrated, when you helped, and when you imitated. Try to take some notes, perhaps by using the form on the next page. We have put an example in the form to show you one way that might be helpful. The example comes from 18-month-old Landon, playing ball with his mom on the living room floor. The form shows the ways his mother followed his interest in the ball and joined him in ball play without redirecting him. Read it through, and then imagine your child’s favorite toy or object play routine. Think about how you could use narration, helping, and imitating with your child in that routine. Then think through a caregiving routine, like bath time. How could you use these strategies during bath time?

  Summary of Step 5

  If you have followed along and carried out the preceding activities, you will have found a number of ways to follow your child’s interest into an activity and join him or her without redirecting your child to a different activity. After you have carried out one of these practice activities, look at the following checklist and see if you agree with most of the statements. If so, you are now armed with important skills for increasing and supporting your child’s attentional focus on you—knowledge you will use for the rest of the chapters in this book. If not, go back through the chapter again, following along and trying each new activity multiple times with your child over the next week or so. Take your time to master these skills. There is no rush! You and your child will both enjoy your interactions a lot more when you can incorporate these skills easily into your play.

  Activity Checklist: Am I Following My Child’s Lead?

  ____ I followed along with my child’s interest for a few minutes and did not try to redirect it to other activities.

  ____ I was face to face with my child, and my child was well positioned to notice me.

  ____ I watched my child’s actions and narrated what my child was doing or looking at for a little while before I touched his or her toys.

  ____ I joined in by imitating what my child was doing, including making sounds.

  ____ I helped my child by making it easier for my child to reach his or her goals, by repeating the activity, and/or by handing over objects he or she wanted.

  ____ My child looked at me from time to time.

  Here is an example of “mixing them up.”

  Two-year-old Dominique and her father, James, are playing on the floor with toys. They have a bag of blocks in front of them, and as James watches (active listening), Dominique reaches into the bag and pulls out a block in each hand. “Oh, you like those blocks,” he says (narrating), and James hands her another one (helping) and says, “Here you go,” as he holds out his other hand. Then he says, “Here, Dommy, can Daddy have a block?” She takes the offered block and releases one to his hand. He has two and puts them down in front of her (helping), stacking them up and adding a few more to the stack. She looks
at the stack, and he begins to add sound effects (whistles) and make a bigger “display” of stacking the blocks, hamming it up and making it a fun spectacle. As she watches him, smiling at his sound effects, he offers her another block (helping), and she puts one of hers on the stack and takes the offered one. He immediately puts one on the stack (imitating). James and Dominique each add blocks to the structure (imitating) while he narrates, “Another one, and another one, and another one,” until they crash. He says, “Crash!” in a big voice (narrating), and they share looks, smiles, and laughter. Dominique begins to build the tower again, and he follows along, narrating, helping, and imitating, while the game is repeated.

  In this example, James uses active listening, narrating, helping, and imitating to follow Dominique’s interest in blocks. He does not try to change the activity or direct her to something else. He stays with blocks and follows her interests and reactions as he tries one thing and then another to see how she will respond. He is a great playmate! They create a fun game, and he has her full attention as he sits across from her, helping her create fun routines with the blocks. Her attention lasts a long time, and they have lots of back-and-forth interactions with the blocks, each one a learning opportunity for her. She has not stacked blocks before—look at how fast she learns this from him!

  Chapter Summary

  We have been discussing ways to increase your child’s attention to you and foster face-to-face interaction. Watching your child to see what he is paying attention to will tell you where the spotlight of his attention is falling, so you can join your child on the stage, inside that spotlight. Carefully positioning yourself, so that you and your child are facing each other without too much distance between you, gives your child a very clear opportunity to look at your eyes, face, and expressions and to learn about all the social information that comes from faces. Although at first this may seem awkward, you will find that it becomes easier and easier with practice. This kind of face-to-face interaction is great for play, but it will also help you provide many more learning opportunities for your child during daily activities. Remember the six main activities described for Step 5 (toy play, social play, meals, caregiving, book activities, and household chores), and try to use these techniques in each of them.

  We have also described some ways to increase your child’s attention to you during activities. The most important of these are the “big four.” The first two of these are (1) active listening while interacting with your child, by watching what she does and commenting on it; and (2) narrating her activities in short phrases and single words, while joining in and following rather than trying to redirect or interrupt your child’s activities. We have added the activities of (3) helping and (4) imitating as other important ways of joining your child and increasing your child’s attention to you. We know that it is more natural for some parents than for others to chat and interact with their young children face to face during caregiving and play routines. For young children with autism, increasing the amount of time they have people inside their spotlight of attention is absolutely crucial to their progress. You will be joining your child in things that your child already loves to do, and joining a happy child is a fun activity for most parents. Have fun practicing these steps!

  5

  Find the Smile!

  Having Fun with Sensory Social Routines

  Chapter goal: To help you increase your child’s smiles and laughter during face-to-face social games, songs, and social exchanges. The more fun your child is having, the longer your child is attending and interacting with you, and the more learning opportunities you can provide.

  This chapter assumes that you feel comfortable and successful with the skills from Chapter 4. If you have started spending more time interacting with your child during play and daily routines, and have been rewarded with more eye contact, more gesturing, and even some smiles from your child—and if you’ve been checking your Refrigerator List and also reviewing the Activity Checklists to help you remember the strategies—you are ready to add to what you’ve learned. In this chapter and each chapter that follows, you will add a new set of ideas and strategies to the previously learned skills that you will continue to practice.

  WHY HAVING FUN TOGETHER IS SO IMPORTANT

  This chapter focuses on increasing the fun quotient (FQ) of the activities you and your child do together. Fun is an important part of helping your child learn for numerous reasons, especially these six:

  1. More fun = faster learning. People of all ages want to continue activities they’re enjoying. This seems so simple—but fun keeps both you and your child at an activity, and for your child more practice leads to faster learning.

  2. More fun = more learning opportunities. The longer the two of you interact, the more learning opportunities you will provide for your child.

  3. Adding fun to a learning activity aids the learning and memory process. Pleasurable activities result in much faster and durable learning than carrying out activities that do not have any emotional meaning.

  4. Your child’s cues that tell you she wants you to continue a fun activity are the basis for your child’s learning to communicate. Looking and anticipating, smiling, reaching, or bouncing with excitement can all be developed into clear gestures, words, and eventually sentences! This is one of your most powerful communication-teaching opportunities as a caregiver.

  5. A favorite activity is its own reward! Repeating an enjoyed activity after your child communicates wanting more provides a strong reward for your child’s communication. The power of teaching through play is built on this natural reward system.

  6. Being a very frequent source of fun and pleasure increases your child’s attention to you at all times. As your child learns what kinds of fun activities the two of you can do together, your child will be looking for more and more opportunities to do them with you, which means more engagement, more communication, and more learning opportunities.

  What’s Happening in Autism?

  Children with autism do not seem to experience as much natural reward in social interactions as other children. Based on research conducted by one of us authors (G. D.),1 we think that one of the basic biological differences underlying autism is this decreased internal reward from social interactions and engagement. The good news, though, is that this biological system is moldable and responsive to experience. Through enjoyable play experiences, you can increase your child’s experience of pleasure in social interactions and his internal motivation to seek out and enjoy social engagement. This paves the way for more interaction and more learning opportunities.

  Why Is It a Problem?

  Not finding social interaction as rewarding as most other children means that children with autism are not seeking out as many opportunities to interact with others as other children do, and that’s a problem, because humans learn so much from these interactions. We learn communication, language, object use, imitation, play, friendship, pretending, emotional intimacy—all aspects of mental and emotional life—not so much from school or other organized educational activities, but in the ebb and flow of daily family life. We think that this reduction in learning opportunities day in and day out, which results from fewer interactions, adds to the social-communicative delays in autism. Let’s consider this example of a little boy with autism:

  I (S. J. R.) met 17-month-old André at his home, with his new baby sister, 4-year-old brother, and parents all together. The parents had just recently recognized his ASD and had received a diagnosis that week. As I entered the house, all of the family members were in the main room except André, who was alone in his parents’ darkened room, holding three figures from Toy Story. His parents told me that when he could, he spent his time either there or in a closet, and they had to keep all the doors closed to keep him in the main room. He held the figures in his hands, then dropped them together onto the carpet and circled around them, watching them, then picked them up and held them together in his hands, and then dropped and circled aga
in. He noticed me but didn’t really look at me, and his handsome little face was quite serious. This went on until his father led him by the hand out of the bedroom.

  I asked his parents to show me André’s play routines. His father carried out a lively roughhouse game involving flipping André onto his shoulder, “airplaning” him around the house, and then somersaulting him down to the floor. André smiled delightedly during this game, and when it was over, he lay on the floor, smiling and looking at his father with his big brown eyes. Dad scooped him up again, and the game was repeated. His mother also had play routines that André enjoyed. She sang “Itsy-Bitsy Spider” to him as he lay on the floor, using some hand motions and creeping her fingers up his chest when the spider went “up the water spout.” He smiled happily, looked directly at her, and waited eagerly for her to repeat it when she finished.

  So here was the fun quotient (FQ): The parents had some great tools to work with. They instinctively knew the power of these games. André did not try to leave to play with his figures. He stayed with these games until his parents and I began to talk and the parents stopped initiating the games. Then he took his figures and returned to the bedroom. André’s parents and I talked about how to increase the number of fun social games they played with André each day.

  When I walked into the house 1 week later, I was amazed at the difference. The figures were up on a shelf and out of the way. André was on the floor with his father, completing a puzzle when I arrived. His parents reported that they had tried to engage him frequently during the day, and the more they tried, the more he responded. As I watched each of them take turns playing with him, I saw André playing happily with his parents, using his eyes, hands, and voice to continue games when his parents paused. What’s more, when they stopped playing for a minute to talk, André directly approached one of them to start another game. He initiated social interactions again and again. His face was lively, and he was highly motivated to interact throughout the hour.