An Early Start for Your Child with Autism: Using Everyday Activities to Help Kids Connect, Communicate, and Learn
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As your child becomes more skilled at giving the object and making eye contact for help, wait for them to occur together before you give help, and reward them consistently when they do by immediately helping your child. Your child will learn that giving plus making eye contact equals a powerful communication.
Here are some ideas for how to set up activities for which your child needs your help:
Use toys or items that your child cannot activate or act on without you: bubbles, balloons, kazoos, other musical instruments, or spinning tops and gyroscopes. When she gives you the item, blow it, play it, or make it go.
Divide drinks and snack materials into smaller portions or pieces, and teach your child to offer you the bowl, plate, or cup to request more from you.
Package pieces of favorite toys (puzzles, blocks, pegs, windup toys, little cars, etc.), in containers, and give them along with the script.
Activity: Teach Your Child to Give in Response to Your Open Hand
and the Words “Give Me” in Many Situations
Here are some ideas for encouraging your child to give you objects in response to your cues in a variety of situations:
Ask your child to give you bites of dry cereal, crackers, or other finger foods during feeding activities at the table. Put out your hand, say “Give me,” and pretend to eat it. Really ham it up with sound effects and smiles, and then give the food back and thank your child.
If your child picks up a piece of food and doesn’t want it, ask for it back with “Give me.” Or, put something on the high chair tray or your child’s plate that your child does not want. As your child picks it up to get rid of it, immediately ask your child to give it to you by extending your hand and saying, “Give me,” so you can remove it.
At the end of a meal, have your child “give” a spoon, plate, or cup before you take it off the tray and lift him out of the chair. This is helping with “cleanup,” a nice habit to cultivate.
During diaper changing, hand the diaper to your child and then say, “Give me.” Offer your hand, take the diaper, thank your child, and continue the change!
During bath times, ask your child to give you various toys she is playing with, and then give them right back.
During dressing, have your child’s socks and shoes right there beside your child. Hand the sock to your child (while saying, “Here’s sock!”) and then say, “Give me sock.” Do the same with shoes.
During object play, ask your child to “give me” a block, a puzzle piece, or whatever little object is part of the play. Go ahead and put it in place, and then give one to your child. This is turn taking, and you are each giving the other an object and a turn. Very nice!
Practice “Give me” frequently during the day, two or three times in each activity, until it is learned. Then keep it up.
Summary of Step 1
If you have followed along and carried out the preceding activities, you now have ideas for how to help your child give you objects throughout activities. This step begins the process of using joint attention to share things for help. The next steps will address how to expand the skill into sharing thoughts and feelings about the activities, but for now, see if you agree with most of the statements in the following checklist. If so, you are now armed with important skills for teaching one particular type of joint attention—knowledge you will use in Step 2. If not, start experimenting during play and caregiving routines until you have found some methods that work for each statement.
Activity Checklist: Am I Teaching My Child to Give Objects?
____ My child and I regularly take turns during object-based joint activities.
____ I know how to pause and wait during my turn for my child to look and/or respond to me with a behavior.
____ I have set up various objects in containers, and my child gives them to me for help.
____ I provide clear cues for my child to give me objects by stretching out my hand and using simple language in my request.
____ I make sure to give each object right back to my child.
____ I have ideas for how my child will need my help during object-based activities (toy play, mealtime, bath time).
Andrew’s parents have created several turn-taking games and are now ready to teach their 18-month-old son with autism how to give objects. They decide that creating opportunities in which Andrew will need their help might be more rewarding to him than taking the object out of his hands. With bubbles, Andrew’s mom begins by placing the bubbles with the lid tightly closed on the floor, where he can easily see and touch it. As soon as Andrew spots the bubbles, he rushes over with excitement and picks up the container, ready to play; however, he quickly realizes that he cannot open the lid by himself. This is where Mom comes into action! Before Andrew becomes frustrated, she says, “Andrew, you want bubbles? Give me,” and extends her hand (palm facing up). She waits a second to see if Andrew will comprehend the action, and when he does not respond, she adds, “I’ll open bubbles. Give me,” and again moves her hand closer to him. When he does not respond, she quickly helps him place the bubbles in her open hand and without delay unscrews the lid while saying, “Open bubbles” and then “Blow bubbles,” followed by blowing bubbles for the two of them to pop. She opens and blows right away to reward his giving.
After blowing bubbles a few times, Mom closes the container lid and hands the bubbles back to Andrew. He tries to open the container and cannot. Again Mom says, “Give me bubbles,” and extends her hand toward Andrew. This time Andrew holds out the bubbles, and she helps him place the bubbles in her hand while saying, “Give me bubbles.” Again she quickly opens and blows the bubbles for Andrew to enjoy, and together they pop, clap, and stomp on bubbles. She closes them and gives them to him again. This time he puts them directly into her outstretched hand. Within a few more practice sessions, he routinely gives them to her, and even picks them up from the table and offers them to her for help, but not always with eye contact.
Now Mom takes the bubbles from him, but then waits momentarily before opening them to see if Andrew will look up at her. This is a change in the routine, and Andrew does look up at Mom to see what happened. She immediately responds by opening and blowing bubbles, and in doing so she rewards Andrew for combining his eye gaze with the gesture. She doesn’t expect Andrew to look at her every time he gives her an object (no child does that), but she does want it to happen more often and become easier for him to do.
Joshua is a 3-year-old with autism who loves playing with trains. His dad has developed reciprocal back-and-forth games with other toy activities and sensory social routines, but does not feel successful when trains are involved. Joshua is protective of his trains and has his own agenda for how the game should be played. This usually involves lining up and rolling the trains on the carpet, and he doesn’t want Dad to touch them or change the routine. Joshua’s dad thinks that building in opportunities for help might work in his favor for creating a joint activity routine with trains. He decides that using the tracks, which Joshua cannot do alone, may be even more appealing to Joshua than running the trains on the carpet.
Dad begins by connecting some track sections together as Joshua is rolling trains on the floor. He quickly shows Joshua how to roll trains on the track, and them gives them back fast. Joshua loves this! It’s a lot easier to roll trains on the track than on the shag carpet. After Joshua rolls the trains back and forth a few times, Dad takes out a piece of track, then another, until there is only one short one left. Joshua wants a longer track and reaches for a piece, trying to fit it in, but he can’t. Dad reaches over to help. Joshua wants another one, and Dad helps again. Joshua picks up the next one, but now Dad extends his hand and says in simple phrases, “Need help? Give me.” Joshua gives it, and Dad puts it in right away. Joshua then picks up the next piece, and again Dad says, “Give me.” After another piece, Joshua looks at Dad and gives a track without any cues from Dad—spontaneously combining gaze and gesture to get help.
Step 2. Teach You
r Child to Show You Objects
Rationale. Showing involves sharing interest in an object by getting your partner to look at your object. Children hold things in front of parents, make eye contact, and draw their parents’ attention (often by vocalizing), so that the parents will look at the object and make some sort of comment. It’s a very important skill, because it gets people to label objects and so builds children’s vocabulary. It also opens the door to social attention, praise, commenting, and other intrinsic features that motivate children to want to share things with others. How can you help your child learn about showing?
Activity: Help Your Child Learn about Showing Objects
Here are some ideas for motivating your child to show objects:
First, show your child things. While you are in front of her, say, “Look! Look at the [object],” and hold the interesting object in front of your child. This should encourage your child to shift her gaze to the object. As soon as she does, name the object. Do this many times each day with objects your child is interested in.
If your child reaches for the object after you show it and her gaze shifts to the toy, hand it right over. This rewards your child for looking when you ask her to.
Think of the toys, materials, and objects your child comes into contact with each day. Since you and your child are already taking turns with these items, start holding them out to show what it’s called, how it works, or what new actions can be done with it before you give it.
During toy play, hold up an object and call your child’s name: “Alex, look!” When he looks, name it (“It’s a ball,” or “See the balloon”), then do something with it (roll or throw the ball, or let go of the inflated balloon). Pairing the concept of “showing” with a fun and interesting effect also rewards the look and is likely to strengthen your child’s response. He will understand how fun and exciting it is to pay attention to Mom and Dad when they say, “Look!”
At meals, while your child is focused on his plate, pick up a container of a highly preferred food and say, “[Name], look” while showing the container. After your child looks, hand over some of the food.
In the bathtub, show your child different materials or new actions to do. First call your child—“Carissa, look”—and when she looks, hold out the toy (“See the duck”) and perform the action (make the duck tickle Carissa or splash the water).
At bedtime, as you are looking at a book with your child, point to a picture while saying, “Look, it’s a [object name].” When your child shifts his gaze to the picture, make an interesting effect (sound effect or action with the book).
Activity: Teach Your Child How to Show Things to You
In Step 1, you taught your child how to give for help by making a specific gesture (your outstretched hand), saying, “Give me,” and then helping your child give over the object. What you will teach your child now is how to show things to you by building on the “give.” Once your child consistently looks when you show him objects, you can begin to teach your child how to show.
Here are some suggestions:
Find a time when your child is holding an object. Get right in front of her, and then say, “Show me. Show me the [object]”—and hold your hand out to your child as if you were requesting a “give” (your child should be able to give easily before you start working on how to show). Be sure to emphasize the word “show,” because that will be the cue that tells the child that you are not asking her to give it to you, but rather to show it to you. When your child tries to hand the object to you, in response to your request, don’t take it; instead, admire it very enthusiastically (e.g., “Wow! What a cool bear!”) and let your child keep it. Your child has placed the object in front of you, and your enthusiastic attention is the reward for showing.
Practice this many times a day, in many different activities. You can touch the object to admire it, but you don’t want to break your child’s contact with it. Showing means holding something out for another to see without giving it, and this is what you are trying to teach.
After your child is routinely holding the object out toward your hand when you say, “Show me,” stop offering your hand and see if your child can respond to the words alone. If he does, admire it enthusiastically as before. If not, then offer your hand partway (partial prompt), but not all the way. As you keep practicing, do less and less with your hand until your child is responding just to your words.
Now, after your child is showing objects to you consistently, wait for eye contact. Ask your child to show, but hold back your enthusiastic comment until your child looks at you. Your child may well look at your face to see why you are not responding. As soon as she looks, admire the object enthusiastically. Continue to wait for the gaze combined with showing to comment; expect your child to show and look at you. If your child doesn’t look, then quietly speak her name, make a sound, or draw her hand to your cheek; once you have the gaze, respond enthusiastically! Continue this way, slowly fading your prompts. Your child will likely begin to show while making eye contact and to look more often.
Note: Be sure to name the object as you admire it, every time. For young children, showing is a powerful way to elicit words from parents, and it helps build their vocabulary. A typical response we use is “Car! What a [neat, cool, big] car!” In this response, the child hears the key word twice. Language learning is a secondary goal here (and everywhere).
Think about several daily activities you do with your child—breakfast, getting dressed, toy play, snack time, diapering, sensory social routines, lunch, running errands, going to the park or playground, reading books, bath time, and bedtime. How many different objects do you and your child come into contact with? Take advantage of these different activities to help your child learn to show different objects. If you can practice this two or three times in four to six activities each day, you will be providing your child with lots of learning opportunities.
Be sure to continue to show your child objects and use the “look” instruction all the time you are teaching “Show me.” Showing and looking when others show are two sides of the same joint attention act.
Be sure to continue to use “Give me” throughout the day, so your child doesn’t forget about the correct response to “Give me” while you are focusing on “Show me.”
Summary of Step 2
If you have followed along and carried out the preceding activities, you will have taught your child to show you objects on request. See if you agree with most of the statements in the following checklist. If so, you are now armed with important skills for expanding your child’s joint attention skills—knowledge you will use in Step 3. If not, go back to the start of this section and start experimenting during play and caregiving routines until you have found some methods that work for each statement.
Activity Checklist: Am I Teaching My Child to Show Objects?
____ I have ideas for what objects I can show to my child.
____ I am able to elicit my child’s attention to the object by saying, “Look at the [object].”
____ When my child looks at the object, I quickly name it and do something fun or rewarding with it that my child enjoys.
____ I know how to show different objects to my child across different activities.
____ I know how to help my child show me an object by saying, “Show me the [object],” and extending my hand if needed.
____ When my child shows an object by handing it to me, I do not take the object, but instead respond enthusiastically with positive attention and praise.
____ My child is able to show objects to me with eye contact (although it may not happen every single time).
What about Andrew? Andrew loves water, and his parents think that bath time might be a fun time to show different objects and actions to him. Dad goes through his usual routine of filling up the tub with bubbles and placing Andrew in it—but instead of dumping in all the toys at once, he decides to show each one to him, starting with a plastic fish. Dad says, “Andrew, look,”
and when Andrew does, Dad responds with “It’s the fish,” and hands it over to him. He lets Andrew have a few minutes to play with the fish, describing the actions he does with it and doing fish faces for Andrew to imitate. Next he says, “Andrew, look what I have!” He waits for Andrew to look up before spraying him with the squirting whale, a routine he loves. Andrew laughs and reaches for the toy, which Dad labels, “It’s a whale.” As he washes Andrew, Dad continues holding up an object every few minutes to show to Andrew, and waiting for him to look before naming it. By the end of bath time, Dad is surprised and delighted at how many times he has been able to get Andrew’s attention by saying, “Look,” and how quickly Andrew has learned the routine.
What about Joshua? Joshua’s mom wants to engage with her son when he plays with trains. She thinks about what she could do that might make him enjoy showing his trains to her, and she decides that adding train sound effects and singing some of his favorite lines from train songs might work. The next time Joshua is holding a train, Mom says, “Show me your train,” and holds her hand out. He doesn’t want to give her his train, so he ignores her request. Mom repeats her request and lifts his hand in the air a little. She’s careful not to touch the train or his hands too long, because she doesn’t want him to think she’s trying to take it away. As she helps Joshua show the train, she responds with “Ooh, I see the train. It goes choo-choo,” and she moves her hands in a circular motion. She makes a little song and dance out of it: “The train goes chug-a-chug-a-chug-a-chug-a-choo-choo!” She stops, and he looks up for more. Then she asks Joshua again to show his train, and again slightly lifts his hand toward her while singing the verse. She decides to elaborate the routine and sing the “Little Red Caboose” song in its entirety with gestures, so that Joshua can enjoy the activity a bit longer before she asks him to show a train to her. Once she has finished, Mom says, “Joshua, show me that train,” and points to a different train on the ground. Joshua picks it up and, while he doesn’t yet hold it out to Mom, he does look from the train to her. Mom responds immediately, “There’s the train! I see it!” and extends Joshua’s hand toward her, followed by singing the song. Mom continues the routine, asking Joshua to show her a different train, helping him do the “show” gesture (if he doesn’t respond on his own), and responding enthusiastically. She also starts pausing briefly for him to look at her before singing the song, so that she and Joshua can share the excitement.