Building Communication and Independence for Children Across the Autism Spectrum releases November 19, 2020.
I wrote this book for educational professionals and parents helping children across the autism spectrum become captains of their lives. To accomplish this, carefully choose and work effectively on functional goals that each child is developmentally able to accomplish. These goals should be valuable now and in the future and improve that child’s personal safety, happiness, independence, and productivity.
Through case descriptions and detailed procedures for meeting specific goals, nine children across the severity range of the autism spectrum illustrate teaching methods that are supported by research and by my extensive experience as a speech/language pathologist and autism consultant. Among the evidence-based practices woven through the book are modeling, prompting, reinforcement, naturalistic intervention, social narratives and visual supports. But therapeutic intervention balances art and science, and it’s vital that children build positive associations with teachers’ words and behaviors. Therefore, the book includes interaction tips such as “Just start,” which I often recommend to minimize resistance to transitions.
“Just start” means that instead of waiting until a child can show you he is ready to work, or saying “If you don’t…then you can’t…” or otherwise getting into a power struggle, you just start the activity yourself. Frequently, the autistic child is resisting because he doesn’t understand what is expected or doesn’t believe he can do it.
Calmly and gently, just spin the spinner and move the game pieces, or do the first few math problems, or read the directions and answer the first question on the social studies paper. Then build in pauses and let the student finish an answer or move a game piece that you can’t reach. Gradually let him take over. Offer help when he is struggling.
Say “I’ll help” to really mean you will give reassuring assistance. When children hear the words “I’ll help,” they should be thinking “Oh good, then maybe I can do it,” not “Uh-oh, someone is going to try to force me to do it.”
And why is the child refusing in the first place? With autism, transitions and shifts of attention are difficult, surprises are generally unwelcome, and predictability and sameness are comforting. So it is not surprising that “No!” is a common response to instructions or suggestions that involve a change of focus or activity. Since this resistance is often immediate and reflexive, I refer to it as the “Automatic No!” At times it seems almost like a startle response. The “Automatic No!” generally starts as a defense against something the child finds alarming, but it can grow into a strong resistance to even mild expectations. View it as a defensive reaction that may or may not signal a solid refusal. Try to interpret and accept it as if the child is saying “Wait a minute, what!?” instead of “No!”
Most of the book lays out specific procedures to overcome obstacles that frequently interfere with successful interactions. Three interspersed chapters expand on the key, evidence-based, instructional methods, and describe other important skills to teach, with commentary on behavior, tracking progress, generalization, and modifications for adults.
The nine children in this book, composites of the many I have known, are grouped according to their communication development and include non-speaking children, those with moderately functional speech or atypical language such as echolalia, and the highly verbal individuals who until recently have been diagnosed with Asperger syndrome. There is a large section on intervention for echolalia. It includes three-year-old Lucas who needs more conventional ways to communicate his needs, wishes and ideas.
Young children often need action from someone else to fix, open, zip, tie, or push things or to just “help.” Children on the autism spectrum often don’t even realize that asking for help is an option and don’t approach others for assistance. Lucas has learned that adults can help him, but he echoes their words to signal his need, saying things such as “Do you need help?” “Can you do it all by yourself?” and “Let me help you.”
He does not reliably approach an adult, often just fussing and saying these words without directing them to a listener. Since he doesn’t directly request action from you, you’ll need to physically prompt him. You, or a silent third person, seeing that he needs assistance, could help him hold out the ends of his jacket or a box he can’t open and then you say “Please zip” or “Please open it” as if directing yourself. Don’t say it with a questioning intonation like “Please open it?” or that’s probably the way he will say it too. You are modeling a polite imperative and Lucas will echo your intonation as well as your words.
If you know a particular directive is familiar to him, but he can’t remember what to say right now, you can say “Please…” as a prompt and he may finish with “help,” “zip it” or “open it”. Again, be sure your “please” prompt does not have the rising intonation of a question. And be careful to avoid frequently responding “Okay” or “Mom will do it” after he directs you. Either do what he has asked without comment or give a variety of different responses, so he won’t think he’s supposed to repeat the whole thing, as in “Please zip it okay.”
This is one small part of the goals for Lucas. In addition to directing, his goals will address other communicative functions like requesting, protesting, answering, and commenting as well as referring to himself as “I” instead of “you” and beginning to interact with other children. Sample goals for the other eight children, Rebecca, Arnie, Darius, Seth, Terek, Mia, Grady, and Evan include:
- Transitioning from a three-dimensional object system to picture-based communication
- Establishing cooperation and joint attention in structured teaching or play-based sessions
- Developing basic receptive and expressive spoken language
- Replacing echolalia with more conventional requests, comments, greetings, protests, answers and questions
- Supporting group participation, conversation, and peer interaction
- Increasing independence in daily routines, schoolwork, and pre-employment tasks
- Modifying communication to decrease refusal and aggression and to develop more effective expression of needs, knowledge and opinions
Communication, social behavior and thinking skills are braided together for all of us, with or without autism. The unraveling of one of these strands significantly impacts the others. But growth in each of these areas supports progress in the others and strengthens the whole person.
Growth, change and progress can, and should, continue for a lifetime.
To purchase Building Communication and Independence for Children Across the Autism Spectrum: https://intl.jkp.com/usa/building-communication-and-independence-for-children-across-the-autism-spectrum-2.html