Engaging Young Children Engaging Young Children with Autism Spectrum with Autism Spectrum Disorders:Disorders:10 Steps to Success!10 Steps to Success!

Dana Childress, M.Ed.

Partnership for People with Disabilities

VCU

dcchildress@vcu.edu

At 11:30, You Will Walk Out At 11:30, You Will Walk Out of the Door With:of the Door With:

Information about Autism Spectrum Disorders

New “tools” for your toolbox

Confidence that YOU can make a difference in the life of children with ASD and their families

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ACTIVITYACTIVITY

Seeing the World Seeing the World Through The Eyes of a Child Through The Eyes of a Child with ASDwith ASD

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Definition:Definition:Autism Spectrum Disorders Autism Spectrum Disorders (ASD)(ASD)

Autism spectrum disorders (ASDs) are a group of related developmental disabilities…that affect a child's behavior, social, and communication skills.

American Academy of Pediatrics

http://www.aap.org/healthtopics/autism.cfm

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ASD Causes?ASD Causes?

◦Most cases – unknown

◦Multiple types of ASD likely

◦Genetic involvement

◦In some cases – may see genetic involvement + exposure to some unknown environmental factor

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ASD Incidence & ASD Incidence & DiagnosisDiagnosis

ASD

1 in 110

Children 1 in

70 Boys

Age of Diagnosis 4.5 to

5.5 years old

51%-91% of children show signs before age

3

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Characteristics of ASDCharacteristics of ASD

Social Interaction

◦Reduced attention to faces & voices◦Increased tendency for isolation◦Limited social engagement &

responsiveness◦Less likely to show pleasure in

shared interactions (joint attention)◦Less likely to imitate others

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Social impairment in children with autism violates typical

parent-child interaction.Doussard-Roosevelt, Joe, Bazhenova, & Porges, 2003, p 104

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Characteristics of ASDCharacteristics of ASD

Communication

◦May show less babbling, fewer words◦Less attention to speech & vocal

imitation◦Delayed receptive language◦Less likely to coordinate joint

attention, gestures, gaze, & vocalizations to request

◦Less purposeful use of language

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The strongest predictor of the child’s future gain in language

skills in our study was caregiver utterances that are not only synchronized with

the child’s focus of attention but also undemanding in

quality.Siller & Sigman, 2002, p 85

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Characteristics of ASDCharacteristics of ASD

Play

◦Restricted interests◦Less purposeful play◦Less/lack of turn-taking◦Interest in parts of objects◦May show repetitive play,

movements◦Play is less complex, less symbolic

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In children with regulatory and autistic spectrum disorders,

interactive play uniquely addresses the core deficits of relating and communicating as no other approach can.

Wieder & Greenspan, 2003, p 425

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So HOW do we begin??So HOW do we begin??

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Step 1:

Watch, Listen, & LearnWatch, Listen, & Learn

Sit back and observe - child, parent-child interactions, the environment

Ask the parent/caregiver about the child’s interests, likes/dislikes, what they do together, what makes the child laugh

Purpose:Purpose: Find out about daily activities & routines to determine the context of intervention

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Step 2:

Oh…I See!Oh…I See!

Attach meaning to the child’s sounds, movements, and activities

Describe what the child does

Use short phrases, fewer words

Initially - no expectation that the child must respond

Purpose:Purpose: Establishes that activity has purpose & provides a language model

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Step 3:

Less Talking, More DoingLess Talking, More Doing

Follow the child’s lead but help him structure his play

Use physical and object-based play to engage the child

Use something the child is already doing or playing with

Purpose:Purpose: Helps the child understand that interaction can be okay

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Step 4:

I Can Do It Too!I Can Do It Too!

Start by imitating the child’s movements, activities, vocalizations to enter his play

Imitate without the expectation that he has to do something in return

When all else fails, imitate!

Purpose:Purpose: Develops synchrony between parent and child

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Step 5:

Your Turn, My TurnYour Turn, My Turn

Turn imitation into turn-taking by assuming that it is “my turn”

Use the toy/object the child already has

Closely observe and accept any interaction as the child’s “turn”

Wait for the child to take his turn before play can continue but keep up the pace

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Step 5:

Your Turn, My TurnYour Turn, My Turn

Shape the child’s turn into an appropriate response (gesture, word)

If needed, give 2-3 prompts then help him take his turn (fade prompts over time)

Keep turn-taking going as long as it is fun!

Purpose:Purpose: Encourages expectation that the child must interact

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Let’s See it in Action!Let’s See it in Action!

Circles of CommunicationCircles of CommunicationDr. Stanley GreenspanDr. Stanley Greenspan

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Step 6:

Ta-Da!Ta-Da!

Use high intensity responses to get attention!◦ Big expressions◦ Silly faces

Use anticipatory phrases to entice, prolong attention, and encourage turn-taking◦ Ready…Set…GO!

Purpose:Purpose: Encourages attention to face, gaze, and voice

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Step 7:

The Power of the Pause…The Power of the Pause…Allow for processing time

Create the expectation that the child must respond to continue to game

Be prepared to wait…

A little discomfort is okay but don’t wait for a tantrum

Purpose:Purpose: Allows for processing time and teaches that communication is expected

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Step 8:

Rock the BoatRock the Boat Once you establish or recognize a play routine,

gently change it so that the child must adjust and interact

Keep up the pace of play

Protesting is interaction too!

Use repetition to practice the old and new routine

Purpose:Purpose: Expands the child’s play & communication opportunities

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Step 9:

Wrap It UpWrap It Up

Wrap new learning in something familiar

Watch for the child’s cues

If possible, help him do one more step of the new activity before ending

Purpose:Purpose: Builds comfort with interaction and new learning

Easy New Easy

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Step 10:

One Brick at a TimeOne Brick at a Time

Be patient and understand that helping a child develop his abilities to interact, learn from, and play with others takes time

Interaction should be fun… look for the bright eyes, smiles, and laughs!

Purpose:Purpose: Builds a foundation for effective communication, interaction, and play!

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Okay…one extra Okay…one extra step!step!

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Step 11:Parents Make the Parents Make the Difference!Difference!

Remember your role as coach & support

Parents have the greatest opportunities for intervention

Focus on how THEY can use these steps between visits

Purpose:Purpose: Supports parent-child interactions within the context of everyday life…it works!

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The greatest sign of a The greatest sign of a success for a teacher...is to success for a teacher...is to be able to say, "The be able to say, "The children are now working as children are now working as if I did not exist.” if I did not exist.”

Maria Montessori

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For success in science For success in science and art, a dash of autism and art, a dash of autism is essential.is essential.

Hans Asperger

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Let’s put our minds Let’s put our minds together and see what together and see what life we can make for our life we can make for our children.children.

Sitting Bull

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