Sunday, March 28, 2010

Speechy Sunday - My Bag of Tricks for Autism

Some of you have requested some speech ideas and tips, so I'm trying to honor that. These ideas are just general strategies that work for me, and should in no way to be taken as medical advice. If you have a child or grandchild who needs speech and language support, there is no better way to get it than in person with your very own SLP. You can find a certified SLP in your area by going here.

Today I wanted to talk about some very basic starting places for therapy with children with autism. I usually work with children in early intervention and at the preschool level, so these lists apply best to children under age 6. This is just a brief list of a "bag of tricks" that I might try on my very first visit with a kiddo with autism. Every child is different, but these little strategies and activities are the ones that I've found most successful with the families I've worked with over the years.

My Bag of Tricks: Strategies

Figure out the child’s individual motivators/special interests - Here are just a few of the many motivators/special interests I've encountered with my clients: letters, numbers, dinosaurs, Thomas the Train, coloring, being in small enclosed spaces, dropping toys down stairs/a hill/a ramp, favorite foods, Moon Sand, farm animals, Backyardigans, spinning, jumping, strong hugs, strong back rubs, hard high fives...the list goes on. Sometimes it's hard to figure out a certain child's motivators. Try to think about what the child does when left on his/her own, and sometimes that's a good clue.

Start with teaching requests - (ex: Please, More, I want it) Requests set the wheels of communication learning in motion. They are the first cog to get moving, and often bring other skills along with them.

Pair sounds with actions if you want the sounds to be imitated or used by the child - I often work on trying to get children with autism to imitate my actions first, and then to imitate sounds and actions, as well. Kids play by imitating one another's actions, and often teaching motor imitation can help social language skills, as well. (By the way, here's a cool research article about that.)

Work Hard to Connect with the Child (maybe by using their interests or some fun sensory play)

Make it fun! - I know you have an're an adult working with a child with autism. But try to make "engaging and having a mutually fun experience" be your primary agenda. After engagement, skills will come. Don't worry! (Here's a neat review of some studies that discusses how teaching kids how to play with toys is actually an effective therapy strategy for getting kids to talk more, not just a fun experience.)

Entice the child to want to request and play. - Be a circus act! The more exciting and interesting you are as a playmate, the more you're going to get from a child. That includes attention, language, time, focus, engagement, and even learning. Think about the best teachers you had growing up. Weren't they the ones brave enough to tap dance on the table if the whole class learned their multiplication tables (like my 3rd grade teacher, Ms. English did)? If you want learning to happen, you have to know how to motivate and entice kids into the process.

Be predictable in format, but change it up regularly. - Most children with autism love predictable routines. But be sure to try to build in some changes each week or so in order to get the child used to dealing with unexpected things, and to work on flexibility.

Keep it Short and Sweet (KISS) -Overplan activities, and move on if one is not motivating/fun for the child. I absolutely love book sharing with kids. But many of my students with autism are not into books unless the book is about their special interest. Or maybe they're into books, but only want to turn the pages without actually listening to the story. So, while I try to plan book activities that are exciting like touch and feel books, or books with actions for us to do together, I usually keep these activities short, and abandon them completely if they're not working well. I'll of course keep trying, and eventually, many students will figure out the fun things we can do with books, but I have to remind myself that it's not a failure to stop a planned activity short--it's just smart. Plus, I don't want to lose my "fun cred" with the kid by forcing them to endure a boring activity.

Enlist parents/sitters/siblings as teaching partners - If you've found a fun activity that your client or child loves, by all means, teach the fun activity to the child's parents, sitters, siblings, grandparents, etc., so they can try it with them, too. I really find that I have to "plan for generalization," because many children with autism learn a skill in one setting and have a really hard time using that skill in any other setting. Quickly giving the reins to a parent once a child "gets" an activity, and being there with them to problem-solve how things are going when they're trying it out, is a wonderful way to make that generalization more likely to happen. (If you're interested, here's a neat research article about a parent-implemented treatment for kiddos with autism to help them learn imitation skills.)

Repeat Repeat Repeat - I like to begin playing with kids with autism by showing them a really interesting play routine a few times until they are interested in engaging in the routine with me. And then, once we've done the routine a few (or a zillion) times, I try to back off and see if they will fill in pieces of the routine. I find that once kiddos learn a basic play routine, and begin to be able to predict how it will work, their engagement level really jumps. And when kids are engaged, that's the point where we can get them learning!

So, that's a brief list of some of my top strategies. Now for the fun stuff. The actual activities I like best to spark a connection with a child with autism:

My Bag of Tricks: Activities (with links to toys I like & a brief script you could use to teach a play routine using these toys)
1. Spinning tops (1-2-3-go........uhoh-it stopped!)
2. Pound a Ball Toys (bang bang bang, aaaaand-out!)
3. Trains (1-2-3-go, aaaaand-stop)
4. Cars down a ramp (up up up, wheeeeee down)
5. Toys down a slide (up up up, sliiiiiiide down)

The cool thing about sharing my bag of tricks with you is that perhaps I can convince you that therapy doesn't have to be hard work. It can be fun, and doing something proactive with kiddos with autism, while having fun at the same time, can really boost a family's happiness!

If you're interested, here's a related post I wrote recently about my favorite autism treatment books. And click here for a few of my favorite autism-related websites.

Oh, and by the way, the cute bag at the top of this post was made by my friend Carla. Here's her cute etsy site if you wanna see more of her stuff.

Also, on a completely unrelated note, it made me really happy to read this article today about knitters working to provide free knitted prosthetic breasts to mastectomy patients.

What's your favorite play activity to engage in with your child (or client) with autism?

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