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

by Rogers, Sally J.

  ____ I am using the four-part activity structure inside bath times and other caregiving activities.

  Chapter Summary

  This chapter has focused on how to develop a back-and-forth “dance” with your child during four-part joint activities with toys, social games, and daily caregiving routines. Developing this turn-taking way of interacting with your child and devising these joint activities to frame play and daily caretaking routines involves increased learning opportunities for your child, increased language exposure, increased social interactions, and the opportunity to participate and learn the ins and outs of daily life. Now it’s your turn—have fun!

  ________________________

  1 Bruner, J. Early social interaction and language acquisition. In H. R. Schaffer (Ed.), Studies in mother–infant interaction (pp. 271–289). New York: Academic Press, 1977.

  7

  Talking Bodies

  The Importance of Nonverbal Communication

  Chapter goal: To provide you with ways to help your child (1) learn to express desires, feelings, and interests by using body language, and (2) learn to understand your body language. Nonverbal communication is a foundation for speech and language.

  WHY NONVERBAL COMMUNICATION (BODY LANGUAGE)

  IS SO IMPORTANT

  Although most of us think of speech when we think about children’s communication, there is much more to communicating than speaking. Long before their speech develops, most babies and toddlers become very skilled at getting their messages across by using their eyes, facial expressions, hand gestures, body postures, and sounds. They also learn to understand their parents’ body language very well. Bodies talk! Recognizing and using nonverbal communication teaches them that one mind can choose to send thoughts and feelings to another—through eye contact, actions/gestures, and sounds—and that the other mind can interpret these messages that travel from the body, through the air, into the eyes, and into the mind of the partner. This is what communication is all about.

  Through body language, your child will come to understand that he can interpret your thoughts, feelings, desires, and interests, and that you can interpret his. This is why nonverbal communication is so important: It allows your child a new way of understanding other people and himself as people with inner lives, with mental states that can be shared. In other words, you can read each other’s cues, which in a sense means reading minds! This is how we interact with each other—by sharing what is going on in our minds and hearts.

  And it’s not just that nonverbal communication allows a child who doesn’t speak a way to express himself. Nonverbal communication, most language researchers believe, provides a crucial foundation for speech development. Once a child understands that communication exists, speech and gestures take on meaning. Speech becomes an additional communication system, built on our first communication system, which we call talking bodies.

  What’s Happening in Autism?

  Autism interferes with learning about others’ minds. Young children with autism have lots of difficulty learning that messages are sent from one person to another, from the mind, through the body, and into the eyes, ears, and mind of the other. This process of choosing to send messages and “reading” others’ messages may not seem to exist for them. Many young children with autism seem unaware that communication occurs between two people; they do not recognize the importance of gaze, gestures, speech sounds, and facial expressions. A child who doesn’t know that there is meaning in those signals will not pay attention or look for meaning. Some children move their parents around and push their hands toward things to try to send messages. Some young children with autism do not use any clear signals at all to communicate their needs or wants. Their parents have to decide when it is time for the child to eat, to be changed, to go to bed, without many cues from their child. Other children may fuss or demonstrate distress, but they don’t communicate what their unhappiness is all about, so that their parents have to work very hard to figure out what their child needs.

  Why Is It a Problem?

  When a child doesn’t communicate at all, or communicates distress but not the cause of it, her parents may get so accustomed to making decisions for her that their child no longer has any unmet needs. Life is easy! Everything is being managed by someone else! Why would a child whose every need is met be motivated to start communicating?

  These autism-caused barriers to nonverbal communication can severely delay all communication development, and these barriers to communication can remain in place for many years—holding up speech and language development, preventing social exchanges based on shared meaning with parents and others, and severely limiting children’s access to learning. Before early intervention was available to most children, it was not uncommon for us to see some children as old as age 8 or 10 who were still completely unaware of communication. They were without speech, gesture, or alternative communication, which meant that they were also without social exchanges or interactions with peers and siblings.

  Juliana’s parents don’t know what to do about their 2½-year-old’s mealtimes. Instead of sitting in her high chair at mealtimes, their little girl wants to have access to her cereal, sandwich, and fruit bars while she is moving about the house, cup in hand. To accommodate her—since she screams, throws herself back, and will not sit when they try to put her in the high chair—her parents keep a little stash of food (cereal bowl, crackers, bits of breakfast bars) on a low shelf in the kitchen where she can always reach them. But this means that crumbs and sticky little fingerprints end up everywhere.

  When Juliana wants something special, she pulls her mother by the hand to the kitchen and stands in front of the pantry or the refrigerator. However, when her mother opens the pantry, Juliana has no way to communicate what she wants, since she has not yet learned to point or speak. Her mother has to hold up one item at a time and offer it, and Juliana cries and gets upset each time her mother offers her something she doesn’t want. Since Juliana has no clear gestures, her mother might have to offer 10 different choices to find something she will eat, and Juliana often takes only two bites and then rejects the food and begins the process all over again. This goes on many times a day and is an ongoing source of stress for both Juliana and her mother. Juliana’s aunt criticizes her mother for “spoiling her,” but Juliana is on the slender side for her age, and her mother is really worried about her nutrition. She has no idea how to solve this problem. She wishes that Juliana could communicate what she wants by pointing or labeling.

  What You Can Do to Increase Your Child’s

  Nonverbal Communication

  Developing nonverbal communication—talking bodies—builds a road to speech and language and lays down a two-way communication road to other people. Here are five specific steps you can take to help your young child with autism develop a talking body and take more responsibility for communicating his needs, interests, and feelings—that is, for being a more active communicator:

  Step 1. Do less so your child does more.

  Step 2. Wait a little.

  Step 3. Create lots of practice opportunities.

  Step 4. Persist.

  Step 5. Position yourself.

  In the following pages, we describe how to carry out each of these steps, give you some ideas for activities to try, and suggest what you can do to solve problems that may come up.

  Step 1. Do Less So Your Child Does More

  Rationale. Young children with autism, like all young children, need to learn to use gestures, eye contact, expressions, and sounds to make choices, to indicate what they want, to share their feelings, and to reject things they don’t want. Doing less to anticipate a child’s needs—giving choices among objects, rather than giving your child free access to everything; offering your child more than one choice; or offering your child things you know she does not want—encourages her to communicate.

  Activity: Figure Out How to Encourage Your Child to Communicate More Throughout the Day

 
Spend time over the next few days observing your child during the six types of activities discussed in Chapter 4:

  1. Toy or other object play

  2. Social play

  3. Meals

  4. Caregiving (bathing/dressing/changing/bedtime)

  5. Book activities

  6. Household chores

  Here are some ideas for encouraging your child to do more to communicate:

  In each of the six activities just listed, think about the theme of the activity and how you can help your child do more during the activity. Can you break up his cracker into several pieces for your child to request, or place only a few cookies in his bowl before he has to ask for more? Can you offer more choices during the activity to increase your child’s participation? What about the setup? Do you think your child can be more involved in helping you open up containers, take materials out, choose which items to use? Remember the four-step joint activity sequence of setup, theme, variation, and closing/transition that you have learned in Chapter 6.

  Next, for each one of these four phases, make a list of what actions you could do that will help your child participate more in the activity. (We have provided a form for you to use to keep your list right in this book if you want to. It’s near the end of this chapter.) If you’re not sure how your child might respond, try it and make changes based on what worked and didn’t work.

  Step 2. Wait a Little

  Rationale. One way of doing less is by waiting for a cue from your child before you hand over what she wants. Start to wait for your child to communicate with you about what she wants. You will build up your child’s repertoire of communicative behaviors—gaze, hand gestures, sounds—and your child’s awareness that each of these ways of communicating sends a message and gets her what she wants.

  Activity: Wait, but Actively Watch for Your Child’s Cue

  When your child clearly wants something—to be picked up, to be given a drink, to get a bath toy, to reach a favorite object that you have retrieved from under the couch—hold the desired object up in front of your body and wait. Wait for a small gesture, wait for brief eye contact, wait for a vocalization. Wait for your child to do something to communicate what he wants. Look for eye contact, an outstretched hand, or a vocalization—some sound or gesture that is your child’s expression of his desires or feelings. When you see that gesture or hear that sound, quickly give your child what he is requesting with that single communication.

  Activity: Problem-Solve to Minimize Your Child’s Frustration

  Here are some ideas for problem solving as you wait and watch:

  What if your child uses crying and screaming as the communication, like Juliana? Waiting will only result in more crying. If your child uses crying to communicate, then you will have to start to offer the choice before your child has the idea, before the crying begins. If your child is approaching you to be picked up, notice that the approach is coming before your child fusses to be picked up, bend down, and extend your hands toward your child’s hands. As your child extends his hands to you (there is the gesture), follow with a pickup.

  What about Juliana? Juliana’s parents started initiating the trip to the pantry. While Juliana was doing something else, they would line up three or four favorite foods from the pantry along the edge of the counter. They would then find Juliana, take her by the hand, and say something like “Let’s get some food.” They would then walk to the kitchen, bend down beside Juliana, and point to the objects: “What do you want?” As Juliana reached for one of the items, her parents would take it down, hold it in front of her, and offer it partway, so that she had to reach again toward them. As soon as Juliana reached, they would give her the food, because Juliana had communicated with the reach.

  What if your child just stands there and doesn’t do anything? Get down a favorite item, squat down so you are face to face with your child, and offer the object partway to your child: “Do you want bunny [or other favorite toy]?” As she reaches to take it, say “Yes, you want bunny,” and give it to her. Your child has communicated with a gesture—the reach!

  Step 3. Create Lots of Practice Opportunities

  Rationale. For your child to learn how to use his body to communicate, he will need lots and lots of practice. You can create many opportunities every hour that you are with your child, by not ignoring his needs but finding ways to hold back a little from giving things to your child without requiring him to communicate. The idea here is to create communication temptations.

  Activity: Creatively Hold Back before Giving Things to Your Child

  Here are some ideas for creating communication temptations:

  Before you pick up your child, offer your arms—but wait to pick your child up until she looks at you or raises her arms in response to you. The look can be fleeting at first.

  When your child needs a drink of water, put some water in his cup, bend down so you are face to face, and hold the cup in front of you—but wait to hand it over until your child looks, vocalizes, or reaches.

  Create situations in which your child needs your help. Sometimes children have access to everything they need without needing to communicate to anyone for help. If this is true for your child, you can begin to keep your child’s favorite toys, cup, snacks, or other special objects visible but out of reach (on a shelf or in a closed clear container), so that your child has to request your help to get what she wants. What would this look like? Your child may reach to the shelf, may bring you the container, or may stand there and fuss. You can say, “What do you want?” If your child reaches or points for the object, gestures to be picked up, vocalizes in a way that is not crying or fussing, or looks at you for help, say, “You want the [object]” as you get it. Then say, “Here’s the [object].”

  If your child stands there but doesn’t make any communicative action, help your child make a clear request with his body. You can pick up the desired object and move it closer to elicit a reach (“Want [object]?”), offer your arms to elicit an arms-up gesture to be picked up (“Want up?”), or position yourself at your child’s level and right in front (“What do you need?”) to elicit a brief look or a sound of some type. Pick up the child right away or get the object if your child gives you eye contact or makes some type of sound other than fussing in response to your question.

  If your child is fussing about wanting an object and is headed toward a bigger upset, offer your arms for pickup, pick her up after she extends her arms, lift her toward the object, and watch for a reach. If there is no reach and no gesture, pick up the object with your free hand, but keep it out of your child’s reach; then wait until the look, reach, or vocalization occurs before giving it to her. Or, while your child is still on the floor, pick the object up off the shelf and move it slightly closer to her to elicit a reach before you give it. Because you give her the object right after the gesture, sound, or eye contact, she will learn that it was one of these nonverbal cues that resulted in your handing her the toy.

  When you give your child something, it might still be in the closed container. Then your child will need to give it back to get your help to open it. If he doesn’t readily give it back, extend your hands and say, “Need help?” He will likely hand it to you, but if he doesn’t, help him put it in your open hand. Then open it and give it back right away, saying something like “Here’s the [object]!”

  Instead of getting the one cereal box from the shelf that you know your child wants, get two, including one your child doesn’t like. Hold the two cereal boxes in front of your child to elicit a reach or touch to the one she wants. Or give the child the one she doesn’t want, and when she begins to protest or refuse to take it, say, “Janie says no” (with a vigorous head shake) while you offer your open hand to take back the unwanted cereal. Then immediately offer her preferred cereal box to her, and when she reaches to it, say, “Janie says yes, Cheerios!” while you nod your head yes and start to pour the cereal. Now Janie has communicated two feelings nonverbally—protest and desire.<
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  Instead of picking up your child repeatedly to swing, tickle, or hug him, do the action once and then put your child down. Then look expectantly at your child and wait a second to see if your child comes back for more (“Want more swing?”). If so, there is some body language! Do it again right away (“Yes, Ethan wants swing!”). If your child looks at you but doesn’t act, respond right away and swing. If your child stands there but doesn’t communicate in any way, reach down and offer your arms and wait for the child to reach back. If he does, proceed to swing. If your child does not respond to the offer and is still there waiting, go ahead and deliver the swing or other action again (“Swing!”). Do it a couple of times and then stop again, offer your hands again, and wait, just like you did before. See if your child will reach for your hands, look in your eyes, or make a sound communicating that he wants you to repeat the game.

  Instead of blowing bubbles, a balloon, a windmill, or a noisemaker repeatedly, do it once or twice so your child gets interested. Then get ready to do it the third time, but wait! Stand there with the bubble wand or other toy posed at your mouth, and look right at your child’s eyes. Ask “Blow?” and make a little blow, but don’t blow the toy. Your child may look right at your eyes, may try to blow, may reach out, smile, or make a sound. If your child does any of these, blow! Do this repeatedly, waiting for a communication before many of the blows. But give a couple of “freebies” too, so that this is easy rather than hard, and your child gets plenty of effects to keep her motivated.

  Mealtimes and snack times at the table are great times to practice. Before you put the food on your child’s high chair tray, hold it in front of you and in front of your child, offering it but waiting for your toddler to communicate somehow that he wants it. Give five Cheerios on the high chair tray instead of filling it, so that your child has to request more again and again. Pour a little bit of milk or juice into his cup rather than filling it, so that he has to request more and more. Don’t set out cups of water or snack items for your child to help himself to. Offer all these as choices so that your child needs to request them.