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

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An Early Start for Your Child with Autism: Using Everyday Activities to Help Kids Connect, Communicate, and Learn Page 13

by Rogers, Sally J.


  This variation—adding another person—is enough to increase Alexis’s interest and motivation for the game, and it results in a number of new learning opportunities. Dad could also add a big stuffed animal as a “person” in the game, or he could put a small object (like a stuffed animal or pillow) on the floor between them to circle around. These types of little variations can add interest for your child, and also for you, as you try to think of variations that will work!

  Know when it really is time to end the game. If your child’s responses diminish, and you cannot revive them through variations, it is time to be “all done” and to offer a different choice of activities. If you are bored, it’s time to change. If your child’s responses increase and get disorganized and overactive, it’s time to calm things down. Slow down the game, lower your voice, or decrease the intensity. If that does not help your child calm down during the game, then end the game, say you are finished, and help your child transition into some quieter play with toys.

  Activity: Know When to Use Objects in Sensory Social Routines

  Sensory social routines often involve activities without any objects at all. In songs, finger plays, social games, and physical games, your ability to position yourself and your child for face-to-face interaction is crucial for capturing your child’s attention to your face and to your directed communications.

  But you can also incorporate certain kinds of objects into sensory social routines. The object has to support the goals of a sensory social routine—to draw your child’s full attention to your face and body—so that there will be smiles and expressions of pleasure, and the child will communicate repeatedly for the routine to continue. If you carry out a sensory social routine with an object, the object has to be a special kind of object that will support your child’s attention to you, instead of pulling it away from you and toward the object. For this reason, one rule of using objects in sensory social routines is that only you can handle them. The child does not get to handle and operate them (because this pulls your child’s attention away from you).

  Objects like bubbles, balloons (never let the child have control of the balloon; it’s a choking hazard!), pinwheels, noisemakers, tops, flutes, and pompoms can be woven into powerful sensory social routines. Other examples include wind-up toys, party blowers, Slinkies, rocket launchers, spray bottles with water in them, lotion, and scarves.

  Here are some ideas for using objects in sensory social routines:

  When you use an object in a sensory social routine, you will not take turns with your child in operating the object. You are the sole operator. You will begin the routine by doing something with the object to make a big effect. Watch your child: You want to see smiles, pleasure, and an approach to you or to the object. If your child freezes, looks worried, backs up, or moves away, stop and wait. Try to repeat the action, but very gently, and aim it away from your child’s face and body the second time. Watch for your child’s reaction. If you continue to see worry, freezing, or moving away, put the object away and do something else.

  If your child smiles, approaches, and looks interested or excited, operate the object again, and then pause. Wait for your child to communicate in some way that she wants you to do it again. When you get the communication (which might be a look, smile, gesture, approach, sounds, or words), say, “More? You want more bubbles?” or something like that, and then operate the object again. Keep this going several times if your child maintains interest. This is also turn taking: communicative turn taking. You do something, your child communicates, and you answer.

  Ideally, your child will come right up to you, touch the toy, look for the repetition, touch your face or hands, or otherwise be very excited. If your child doesn’t, offer the toy and entice him to come closer. This is a close-in activity that should be a great source of fun and pleasure for both of you! It is also a powerful communication frame for your child, and in subsequent chapters we will give you many ideas for helping your child learn more ways to communicate his desires in sensory social routines.

  What should you say? Just as before, develop a simple narration that goes along with the activity. A few words and sound effects are important to add. For a bubble routine, a typical narration might be something like this: “Want more bubbles? Want me to blow? Blow! [then blow]. Get the bubbles. Pop, pop. See the bubble? Get it—pop,” spoken as your child does the various actions. Use a similar narration each time you play a specific game. Emphasize the names of things, the actions you are making, sound effects, and little chants like “One, two, three” or “Ready, set, go.” Add sound effects, gestures, facial expressions, and anything else that makes the routine fun and playful for you and for your child. Be dramatic; ham it up! Use your child’s reactions to tell you what creates energy, fun, and excitement for your child without becoming overstimulating—a point we will return to soon.

  Games and Songs with Objects

  Activity: Alternate between Sensory Social Routines

  and Object Play

  Because sensory social routines draw you and your child close together socially and emotionally, they are wonderful parts of all interactions. When you are playing with your child, see what it’s like to alternate between object-focused play and sensory social routines. The object-focused play builds your child’s skills in thinking, imitation, hand and body coordination, and complex play skills. The sensory social routines build social skills, communication skills, emotional connectedness, and imitation. Alternating between joint activity with objects and sensory social routines ensures:

  • Greater enthusiasm, motivation, and energy for learning

  • More learning across developmental areas

  • Reciprocal turn taking and responding inside typical routines and activities

  • More social attunement and engagement

  Keep in mind, too, that when it is time for a sensory social game to end, you will probably be wise to move to an object play activity. This will give both of you a little break from the intensity of welldone sensory social routines! Some children will resist ending a sensory social routine; this is good, because it means that they really enjoyed it! However, if you feel it is time to end (you are exhausted, or it feels too repetitive) and your child resists, you can help the transition go more smoothly by introducing an object or another enticing activity (like a snack), diverting your child’s attention toward the new object or activity, and then leaving the sensory social routine.

  Sensory social routines draw children with autism back into the social world and the pleasure of social exchanges. They are a very important part of our social-communicative approach to early intervention for ASD, and they are used in one form or another by many different treatment approaches.

  Summary of Step 2

  If you have followed along and carried out the activities described above, you will have built up not only several different types of sensory social games, but also your skill in observing and assessing how and when to use a sensory social routine. You will also know when you need to vary a routine, end it, or transition to an object-focused routine. See if you agree with most of the statements in the following checklist. If so, you’re ready to go to the next step. If not, reread this section, try some different routines, and consult with someone who knows your child well if you are having problems trying to come up with some new ideas.

  Activity Checklist: Have I Built Up a Bigger Repertoire

  and Refined the Routines?

  ____ My child and I have built up a repertoire of 10 or so fun sensory social routines, including songs and finger plays.

  ____ I have worked out one or more sensory social routines for most care-giving and play activities of our day.

  ____ My child is active in the games, not just a passive observer or recipient. He or she cues me, one way or another, to continue during pauses in many of our games.

  ____ I have learned how to vary routines, or elaborate them by adding steps, to keep the routines from getting too repetit
ive.

  ____ I can narrate and produce simple scripts for these games fairly easily.

  ____ I have learned the signs that my child is losing interest and it’s time to end the game before my child leaves, fusses, or shuts down.

  ____ I have learned to carry out some sensory social routines with objects.

  ____ I have experimented with going back and forth between toy/object play and sensory social routines with my child.

  Step 3. Optimize Your Child’s

  Energy Level for Learning

  The last step in this chapter involves helping your child find her best energy or arousal level for learning from you in these fun activities.

  Rationale. Children who are overaroused or underaroused are not in an ideal state for learning. Optimal learning occurs when a child is alert, attentive, and engaged—not when he is passive, spaced out, or tired, or when he is overexcited, agitated, or overly aroused and out of control. It’s important to be able to judge when your child is getting too aroused or is not aroused enough, and to take steps within your sensory social routines to optimize your child’s arousal level for learning.

  Activity: Learn to Dial Down the Activity When Your Child Is

  Getting Highly Aroused

  You probably have experienced your child, or other children, getting “revved up” when their parents play with them in a very vigorous way. It’s fun to see children become excited and energized by play. But at a certain point they get so wound up that they aren’t listening, aren’t responding to others, and instead are “over the top.” They are overaroused. They have temporarily lost their ability to control themselves and their own behavior. They may start running around, yelling or screaming, and perhaps getting destructive or aggressive. This is a point when parent–child play or play between brothers and sisters can quickly evolve into a conflict situation, with children being corrected and parents being upset.

  Here are some ideas for heading off overarousal:

  Make the play gentler the minute you see your child getting overly aroused. You don’t need to stop; just get softer, slower, quieter, and less stimulating. You should see your child become less excited quickly.

  You can use sensory social routines to help your child adjust her arousal or excitement levels in many situations. Children who are upset and overaroused for other reasons often calm down in response to gentle sensory social routines. Children who are very upset because they are angry, frightened, or frustrated may be helped by gentle sensory routines involving rocking, hugging or squeezing, or having gentle pressure on their heads and backs. These may be accompanied by your soft and soothing voice singing a calming song, or saying a little chant like “You’re okay, you’re okay, you’ll feel better, you’re okay.”

  Activity: Find Ways to Energize an Underaroused Child

  Children who seem sluggish, bored, uninterested in things, unresponsive or underresponsive to your initiations or to events going on around them can’t learn any better than children who are overaroused. They tend to sit or lie around rather than move around as actively as most young children, who seldom sit still for very long. Their facial expressions look neutral; it’s hard to tell what emotion they are feeling, either in face or in body. They may seem tired. They may do one thing for long periods of time without changing position—watching their hands, staring out the window.

  Here are some ideas to “perk up” or activate an underaroused child by using lively sensory social routines:

  Move the child quickly by bouncing, jiggling, spinning, or using fast-paced actions and songs.

  Use stronger touches, more volume, a bigger voice, more emotion.

  Use physical actions involving rapid or rather jerky movements: fast bounces on your lap or on a ball, lively jumps on a mini-trampoline.

  Use sensory social objects that create big sounds or visual events.

  Use touch to “rev up” an underaroused child: rubbing or squeezing limbs; using lotion; giving foot massages on bare feet; rolling up in a mat; squeezing in a bean bag chair; blowing bubbles on hands, feet, or belly. Be careful with tickles: They are very arousing, but can also quickly become noxious. If the child comes back for more or pulls your hands for more, continue once more, but if not, end.

  Summary of Step 3

  We have been discussing concepts related to your child’s level of arousal or excitement during sensory social routines. You may have observed your child getting too excited at times and either crying, getting really overactive, or becoming disorganized in some routines. You have likely tried to experiment with those overexciting routines by slowing them down, calming them down, or ending them sooner, to prevent the overexcitement. Or your child may be a low-key child with a mellow, laid-back disposition, who doesn’t get excited about much or show many emotional changes. We hope that you observed your low-key child get more excited in sensory social games—more smiles, more animation, more social behavior, more attention to you, more liveliness, more emotion.

  See if you agree with most of the statements in the following checklist. If so, you are ready to move on to the next chapter. If you have not thought much about these concepts with your child yet, spend a little more time observing, playing, and thinking about this. When you see either one of these states (overaroused or underaroused), try to use a sensory social routine that you have developed to help optimize your child’s state—to slow down and reorganize an overly aroused child, or to rev up and energize an underaroused child. Doing both of these as needed will optimize the child’s ability to attend and learn from you.

  Activity Checklist: Have I Optimized My Child’s Energy

  and Arousal for Learning?

  ____ I have become much more aware of my child’s arousal levels across different activities.

  ____ I can see when my child is overaroused, underaroused, or in an optimal state for learning and interaction.

  ____ I have learned how to use some of our sensory social routines to help my child become calmer and better organized when he or she is overaroused.

  ____ I have learned how to manage our routines to keep my child from becoming overaroused and disorganized during our social play.

  ____ I have learned how to use some of our sensory social routines to help my low-key child become more energized and motivated to participate.

  ____ I know what it means for my child to be in an optimal state for participating, and I know how to use sensory social routines to help create and sustain that state in my child for several minutes or longer.

  ________________________

  1Dawson, G., et al. Brief report. Recognition memory and stimulus–reward associations: Indirect support for the role of ventromedial prefrontal dysfunction in autism. Journal of Autism and Developmental Disorders, 3(31) 337–341, 2001.

  2For more ideas and descriptions of games, see www.parents.com/baby/development/intellectual/classic-games-to-play-with-your-baby.

  6

  It Takes Two to Tango

  Building Back-and-Forth Interactions

  Chapter goal: To help you build joint interaction routines and back-and-forth interactions with your child into your daily play and caregiving activities, so your child is more engaged and is communicating more with you.

  WHY BACK-AND-FORTH INTERACTIONS (TURN TAKING)

  ARE SO IMPORTANT

  One of any child’s biggest accomplishments in interacting with others is to learn to take turns. The ability to cooperate in give-and-take exchanges is fundamental to social development and to communication. Think about board games, conversations, the grocery store checkout, religious services, meetings, dancing, children playing pretend—all these social interactions are built on taking turns. Take a moment to notice your social interactions with other people, and look for all of the turn taking that occurs during those exchanges. We are not talking about structured interactions in which one person says, “It’s my turn,” and the other waits. We are talking about the natural turn taking that occurs in adult co
nversations, in parent–child social games, and in playful interactions between young children—for instance, where one child picks up a bucket in the sand and puts sand in, and the other watches and then comes over to put sand in the bucket too. Watch two people interacting, and you will see this natural turn taking everywhere.

  Even the youngest children have a sense of taking turns, which parents often experience while playing with their baby. A parent may make a silly face, and the baby may then look at the parent’s eyes with a delighted smile and laugh. That is the baby’s turn, and the parents are likely to respond by taking another turn and repeating the silly face. This kind of turn-taking pattern also occurs in vocal play. The baby makes some sound just for the fun of it, and the parent takes a turn and imitates the sound. Then the baby takes another turn, imitating the sound again or watching and smiling, and the parent responds again in turn. When babies become toddlers, they continue using this turn-taking structure in imitation and interaction games with adults and with other children. In a very familiar kind of play, a 2-year-old watches another child do something and then imitates it, at which point the other child does it again, and so on.

  In these interactions, what may look like nothing but light-hearted play is actually serious learning. Each person in the interaction fits his response to the other person’s response, and the two partners build their interaction back and forth: Maybe a little boy opens his mouth wide and throws his arms in the air when a block tower topples. His playmate then knocks over a block tower and makes the same gestures. The first child watches this imitation with delight and then builds on it by adding jumping to his feet the next time the block tower falls. Young children use this behavior to learn an enormous amount from other people. They watch a person who is important or interesting to them; they observe the other person’s words and actions; and they hold them in their minds to make sense of them and remember them. They may imitate it right then and there or later, to practice and learn what the other person was doing. This kind of social learning is one way that little children learn so much without anyone teaching them directly.

 

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