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

by Rogers, Sally J.

  Mom gradually starts to pause once she’s pointed to the picture, because she wants Joshua to look at her. Once he does, she makes the whistle sound or names the picture. Over the next few nights, this is their new routine with train books, and it’s not until the next week that Mom helps Joshua point to a picture before naming it or adding the sound effect. She continues pointing to pictures as well, so that Joshua doesn’t have to point to a picture on every single page. This could be too much of a new skill to make him do in just one night. But each night during their bedtime routine, Mom helps Joshua do a little more—point to a few more pictures or wait for him to look at her before turning the page. The next 2 weeks are marked by definite improvement in Joshua’s ability to share books with his mom. He eagerly chooses which books he wants to take to bed, and when Mom asks, “Where’s the red train?” or “Do you see the conductor?”, Joshua is excited to point to the picture and say “Train” or simply vocalize a sound. Recently he’s started pointing to pictures on his own, in anticipation that Mom will acknowledge them or make the sound effect. Mom and Joshua can enjoy their special time even more, now that he has different behaviors to express and share his enjoyment.

  Chapter Summary

  Young children with autism face big barriers to understanding and using joint attention to coordinate and share their interests with others, and their lack of sharing often results in fewer and fewer opportunities to communicate and learn over time. Yet children with ASD are capable of making enormous gains in joint attention and other types of nonverbal (and verbal) communication. The crucial techniques involve creating many, many opportunities for your child to share attention with you, and for you to share with him or her, directing gestures to the child and prompting your child to make gestural responses. Remember that typical toddlers are communicating nonverbally with adults all day long. They have hundreds (maybe thousands) of learning opportunities in a day. You are creating these kinds of opportunities for your child. This is a necessary step for verbal language development. The work you are doing at this level is paving the way for speech. As we have discussed in Chapter 7, gestures and gaze are our first language—a language we use forever in social interaction. It is joint attention that allows your child to share likes and dislikes, desires, interests, thoughts, requests, and feelings about objects and events in the world. Gestures,

  eye contact, and facial expressions give direct access to other people’s thoughts and feelings. Teaching your child how to use gestures and gaze in everyday activities to communicate preferences and interests helps your child learn what communication is all about: It is an intentional and powerful system that influences other people.

  Learning how to communicate through gestures and gaze can prevent some of the problem behaviors that are often associated with autism, by giving children useful communication tools for expressing their needs, preferences, and wants. It provides your child with a strong base for further language learning with built-in, powerful, natural rewards.

  ________________________

  1Toth, K., et al. Early predictors of communication development in young children with autism spectrum disorder: Joint attention, imitation, and toy play. Journal of Autism and Developmental Disorders, 36(8), 993–1005, 2006.

  Thurm, A., et al. Predictors of language acquisition in preschool children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 37(9), 1721–1734, 2007.

  11

  It’s Playtime!

  Chapter goals: To help you (1) increase the number of learning opportunities in parent–child toy play, and (2) support constructive, varied, independent toy play.

  WHY VARIED, FLEXIBLE TOY PLAY IS SO IMPORTANT

  TO LEARNING

  Young children spend most of their free time playing. If they are not in the middle of care routines or naps, they are playing with the people and objects around them. Playtime has a number of important functions:

  1. Young children use play to build new skills—trying again and again to climb the stairs, to put things in and take them out of containers, to push the car, to fit the puzzle piece, or to arrange their toys just so.

  2. They also use play to practice skills they have already masered. It’s easy to see how much pleasure young children receive from “exercising” their skills in play.

  3. They vary their play and try creative new ways to use their toys and other objects. And they can turn almost anything into a plaything—plastic storage containers, rags, boxes, sticks, and sand work, just as well as the newest creative plaything from Grandma.

  4. Young children also use toy play to practice social skills. We see this in the way they like to have others join in their toy play. They learn by watching what others do with toys, and they learn to share, take turns, and cooperate with others during toy play. In pretend play with others, they practice social routines from daily life in their play with dolls, toy dishes, doctor bags, and toy animals. They act out what they have seen people do in real life and what they have experienced in their own lives. And, of course, when a partner is involved, playtime becomes language-learning time.

  What’s Happening in Autism?

  Though all young children enjoy repetitive play (banging a spoon on the high chair, splashing water during bath time, playing with a pull toy), most young children vary their play routines. They do many different activities in a play hour, and they play with an object in several different ways. Young children with ASD usually enjoy toy play as well, and play with a range of objects. They often enjoy puzzles, blocks, cars, swings, and slides, like their peers, and play with them similarly. But their play may differ from that of their peers in these ways:

  • They tend to repeat an act or motion more frequently than their age-mates.

  • They spend an unusually long time with their favorite toys, doing the same thing over and over. They don’t seem to become bored nearly as quickly as other children do.

  • Their play may be much simpler than that of their age-mates. They may get much pleasure out of playing with simple toys, in simple ways, using skills they learned months or years ago, instead of using play to practice new skills.

  • They may play with unusual objects or in unusual ways. They may prefer to carry their cars around, one in each hand, or to line them up rather than drive them. They may enjoy playing with objects like strings, shoes, or other materials and ignore their more typical toys.

  • They demonstrate less interest and skill with pretend play than their age-mates do. Pretending with dishes, dolls or stuffed animals, doctor’s kits, dress-up materials, and similar toys does not seem to interest them, and they may not appear to understand this kind of play.

  •They seem more content to play alone with their toys, and for longer periods, than their age-mates do. They do not seem as motivated to include parents, siblings, or others in their play as their age-mates are.

  Why Is It a Problem?

  Of course, when children are playing alone, they don’t have as many opportunities to learn language as they do when they are playing with parents, grandparents, and older siblings. But the differences in how they play limit their learning opportunities in two other ways as well:

  1. Repetitive, simple play with few objects robs play of novelty, significantly reducing new learning opportunities.

  2. Playing alone significantly limits children’s opportunities to learn not only new language from their partners, but also new play concepts and the social skills and scripts that usually accompany object play. Since children with autism have difficulty imitating others, they actually need more time playing with others, not less, to get the same benefit from social play as typically developing kids do.

  The play that you’ve been encouraging with your child as you’ve read Chapters 4–10 of this book has been aimed at building specific other skills: language skills, social and cognitive skills, and communication. In this chapter, which is centered on constructive play, and the next one, which addresses pre
tend or symbolic play, we focus on play in its own right. Young children with autism will learn more through their play when they can learn to play with lots of different materials and lots of different people, in lots of different ways, in a social and reciprocal fashion. Increase your child’s enjoyment in play, and you’ll increase the breadth of learning opportunities that your child gains from play.

  What You Can Do to Increase Variety, Flexibility, and Learning Opportunities in Parent–Child Toy Play

  Caution! Teaching new and more varied ways to play requires using objects to imitate actions. If your child is not doing this very frequently yet, spend a little more time with the activities in Chapter 8 before focusing on the strategies described in this chapter. Imitating others’ actions with objects is a building block for developing more mature and varied play.

  Building Play Skills from Imitation

  Good news! You already know how to teach your child to expand his play! That’s because teaching play skills is just like teaching imitation with objects. You will use imitation as your main tool for teaching play skills, and you will teach play by using the same four-part joint activity framework that you have been using to build other skills:

  1. You will set up object play opportunities that follow your child’s interests. You will provide attractive materials and interesting activities that motivate your child to play with you, and you and your child will begin to play, following your child’s interest into the materials.

  2. You will develop a play routine, which involves joining in toy play with your child, taking turns, and establishing a main theme.

  3. You will use variation, in which you show your child how to play in new ways and hand over materials to your child and help her imitate you and practice the new ways to play.

  4. For the closing/transition, you will finish the activity when your child’s interest starts to wane; the two of you will then put the materials away and make a transition to another activity.

  Deciding What Kinds of Play to Teach

  How do you decide what play skills to teach your child? You already know more about the answer to this question than you might think. You know what toys your child has, what toys your child likes, and how your child plays with those toys. What you may need are some ideas for new play skills to teach.

  You can expand your child’s toy play skills in two main ways: (1) by increasing the number of toys your child knows how to play with and (2) by helping your child increase the complexity of his or her play. Let’s start with the topic of increasing the number of toys your child knows how to play with. First, you will need to select toys (and household objects that support play, like nesting measuring cups, pan lids that bang, rolling pins and dough) that “fit” your child’s current skills. All children have a wide range of play skills in their repertoire, and your child likely does too. Some of his skills may involve very simple play, play skills he has been carrying out for a long time (like shaking, banging, dropping, watching things move, and mouthing). Others are more mature play skills and involve handling objects in some type of cause-and-effect play, like putting blocks in a shape sorter, putting pieces in a puzzle, or driving small cars around on the floor. (Save the pretend play toys for the next chapter. In this chapter you will be focusing on toys that are interesting because of their cause-and-effect qualities.)

  Start by making a list of all the toys your child has that seem to fit your child’s more mature play skills. Once you have done that, circle the toys that your child currently knows how to play with without any physical prompts from you. These circled toys are your maintenance toys, the familiar toys that your child knows and likely enjoys. You will want to be sure to use some of these every day for play. Put an M for maintenance beside those. Now look at the remainder of the list; there are probably a lot of toys that your child has but does not play with. Circle the five that seem like toys your child could learn easily and would enjoy; these are likely very good choices for the toys you want to teach. Put a G beside those five—those are your goal toys. Gather them up, organize their pieces, put them in an easy-to-reach spot where you can pull them down for daily play. These are the five toys that you will focus on first. The next section will help you develop a teaching strategy. Once your child has learned those five, go back through this process, marking those with an M as well, because your child has now learned them, and choosing five more as goal toys. It is safe to assume that your child could learn to play with one or two new toys every week in a simple way if you play with them daily and help her learn them. In this way, week by week, you will be increasing your child’s repertoire of toy play skills.

  Playing with Cause-and-Effect Action Toys

  Now that you have identified a number of goal toys or household objects to teach that involve cause-and-effect actions, you will begin by helping your child learn how to use each of these objects according to its main theme, the most typical way that other children would use it. You will use the joint activity framework to be sure your child learns both the main theme of each object and one or more variations. You have already begun this work by helping your child learn to imitate actions on objects (see Chapter 8). Here we are focusing on using the same techniques to build up your child’s skill set with toys.

  Helping Your Child Learn the Main Theme of a Number of Toys

  or Objects

  Most young children’s toys have at least one main theme. For books, it is looking at the pictures and words. For shape sorters and puzzles, it is matching the shapes and putting things in. For pegs, it is putting them in the holes. For blocks, it is stacking and building with them. You want to be sure that your child learns how to do the main action that goes with each object. If your child does not know how to play with one or more of his toys, start with that one main object and its main theme. You need only one action to create a theme for the play. If you’re not sure what that is, observe your child’s actions with the objects or think about the intended function of the object. Is it meant to roll, stack, bounce, push, pull, go in–out, or go up–down? Pick a name for the action, and take turns doing it with your child.

  Here is the sequence:

  Bring out the toy. Get into a good face-to-face position with your child, either on the floor or standing or sitting at a little table or the coffee table.

  Put the toy between the two of you. Take one or two pieces, and show your child how it works by doing it—quickly, and with fun sound effects or simple words.

  Is your child interested? Is he looking at the toy, reaching for a piece, sitting down, or watching your actions? If so, then hand your child a piece and see if he copies what you did. If he does, give him a cheer and do a piece yourself, followed by handing your child another piece. He is playing with the toy appropriately! If he doesn’t imitate what you did, help him do it, by physically guiding him through the action. You may have to repeat the action, exaggerating the effect and/or slowing down the motion, so your child can observe and process the steps. Or you might have to start the action and then let your child finish it. If this does not work, then again physically help your child complete the action. Give a cheer and hand over another piece, helping your child again.

  Is your child still interested? Terrific! Take a quick turn yourself, and give your child another piece. See if she starts to do it correctly. If so, wait for her to finish, give a cheer, and give another piece if she is still interested. If not, give enough help so that she is successful.

  Try to give your child three to five opportunities to carry out the single action involved in the activity, or more opportunities if he seems interested (staying seated, reaching, watching). Take turns, hand the pieces over, and help your child as needed. Have fun, label, cheer, and enjoy your child’s efforts to learn.

  Bring this goal toy out for some playtime daily if you can while your child is learning it. It will probably be more fun for your child with repeated experiences.

  Remember to bring out several maintenance toys eac
h day as well—different ones from day to day—so your child continues to practice and enjoy those familiar toys.

  Once your child is using a piece of the goal toy correctly, you can start expanding on his play by encouraging him to put in more than once piece. Set up the toy as you did before, but instead of handing the pieces over one at a time, put two or three pieces down on the floor or table. Pick up one and do it yourself and then wait for your child to get the other. When your child can pick up two pieces, one at a time, and complete the action with both, you can put more pieces out. Remember to take some turns, label the objects, label the actions, show your pleasure at your child’s efforts, and shift toys as your child’s interest wanes.

  In the Appendix at the end of this book is a list of toys to pick from that work well for teaching varied play with young children of various ages.

  Here are some ideas for goal toys involving various types of toys that your child might not be playing with yet:

  Books

  Art materials

  Ball play

  Puzzles, shape sorters, color sorters, pegboards

  Building toys and nesting toys

  Stringing and lacing

  Musical toys (especially rhythm instruments, xylophones, and keyboards)

  Outdoor play—sand, water

  Bath play

  Pretend play sets like a farm set or dollhouse (see Chapter 12)

  Teaching Your Child a Variation on the Main Theme; Variations

  Add Complexity

  Flexible play is very important for learning. You see flexibility when you see your child do more than one thing with a toy. So once your child learns to play with her toys in the main way for which the toy was intended (the main theme), you should introduce a variation. Blocks can be stacked, but also lined up as a road to drive with cars or trains. Connecting blocks (e.g., Legos or Tinkertoys) can be assembled and turned into a helicopter, ice cream cone, or rollers. Children can color with markers, but also with crayons, chalk, and with paintbrushes, and they can make marks, lines, and dots or can trace and color shapes.