I am not an expert on the autism spectrum disorders…..however…..I have done a lot of reading and research, have worked with many families as the speech consult on the team, have learned from many ABA special educators…..and most importantly I have learned from the children that I have evaluated and worked with.
SPEECH AND LANGUAGE CONCERNS WITH REGARD TO CHILDREN PRESENTING WITH AN AUTISM SPECTRUM DISORDER:
Children presenting with an autism spectrum disorder, in my experience, have difficulty with regard to functional and spontaneous communication. What does that mean? Functional and spontaneous language is the words your child uses on her own….without prompting……in order to get what she wants. This means…..she comes up to you and says: “Juice Mama”…..because she wants something to drink.
Spontaneous and functional language is NOT scripted ( I will explain more below)…..and it is not words that are just randomly produced. An example would be this: a child on the autism spectrum may be able to say the word juice, however…..did not want juice. She was just randomly saying the word. And when I work with the ABA teachers…..I have learned that the spontaneous words are called Mands and the words that are produced as a label (I will talk more about labels in a second)…..the labels are called Tacts.
A word that is used as a label….is used just to identify an object…..maybe your little one sees a ball….and she says ball…..or she sees a juice…and she says juice…….the difference between functional spontaneous language that is used with meaning (as a Mand) and language that is uses as a label (Tact)…..is this….when a child is using functional and spontaneous language….they “get it”…..they get that language has meaning and that language “works”….it gets them what they want…..whether it is juice or a ball or Dora on television.
So in my experience I have found that children with an Autism Spectrum Disorder have difficulty with regard to spontaneous and functional language. I did an evaluation the other day….and the little girl was diagnosed with an Autism Spectrum Disorder….and her parents told me that she had about 25 words in her vocabulary….she is 24 months old…..the concern is that she does not use any of these words with meaning to get what she wants. She can say the words if she sees an object. However, all 25 of her words were never used with meaning. Now I can not make a diagnosis….but in my past experience….I have come to learn and understand the signs that cause us to worry…and then my job is to lead the parents in the right direction so that the child gets the services she is supposed to get.
Now the other concern I often see is the limited desire to be social and engage in a reciprocal activity with a peer or caregiver. A child that presents with an Autism Spectrum Disorder…..typically…..does not have that desire to engage in a social activity…which allows them to interact in a reciprocal activity….whether it be rolling a ball back and forth……taking turns blowing bubbles……and engaging in a social activity that demonstrates reciprocity in play (the back and forth activity two people may engage in during play)……and the reciprocity of language (the back and forth language two people have when they have a conversation). So as a licensed speech and language pathologist working in the field since 1993…..when I see a child that has limited functional language and a limited desire to be social……I am concerned….and will be sure to make the right recommendations.
If you think about the word “script” I am sure you think of the words spoken in a play or a movie….the lines you have to learn…..the words you have to memorize….in a play or a movie…what an actor or an actress has to memorize…..”her script”. I have heard children with an autism spectrum disorder repeat entire television shows, memorize the words to a children’s book, repeat commercials on television, remember exactly how to answer certain questions…using the same “scripted speech” over and over again. What is limited in their abilities is this…..the ability to spontaneously and functionally use language. The natural flow of language to answer a question, initiate a conversation, maintain the conversation and use language to indicate a need. Some children may even wake in the middle of the night and repeat scripts from a show they watched on television…and say the same lines over and over again….with really no meaning though…they are not asking to watch the show….just recalling lines.
TOYS AND ACTIVITIES TO ELICIT SOCIAL INTERACTIONS:
The parachute is another favorite speech therapy toy of mine. I have added to the list of my favorites for speech and language delayed children….and also for children that present with an autism spectrum disorder.
A few years back…while doing research on the autism spectrum disorders….and doing reasearch on RDI…(for more specific information and very helpful information…..please go to their website: www.rdiconnect.com )……..well in doing my research I found that I really needed to change the toys I used with children on the spectrum…..I needed to really encourage social interaction….and I needed to stop talking! Why…..because sometimes…..too much talking….is too much for children on the spectrum…..let’s make the goal for her to desire to play with me…..to like my toy so much…that she chooses to engage in the activity with me.
Well…in doing some of my own research about autism spectrum disorders and RDI….and with the help of families I was working with….I was able to better understand the philosophy and the model the RDI purposes. For me….as the speech and language pathologist, working on the team…..as the related service provider…I had to learn how to develop a more meaningful and connected relationship with children on the spectrum…..sometimes without any language at all….and that was hard for me. But I found….and still find….that simple activities like airplane rides on your legs…bouncy on a big yoga ball……singing “row-row-row-your-boat”…..on the floor….holding hands with the little one….and moving back and forth together…….these non-verbal activities….achieved so much non-verbal social language. The eye contact that was established back and forth between me and the child….the smile from the little one…the giggle or laugh…..and then when I stopped…..eventually we would hear a real and meaningful word…..to tell me that she wanted to ”jump” again on the trampoline…..or she would say….”bounce”….because she wanted to bounce again on the big yoga ball. Amazing to hear functional and spontaneous language…that was social and meaningful.
So to add to my list of favorite toys…..I add the parachute…..kids of all ages seem to like this activity. For children that are NOT on the autism spectrum….be sure to use the strategies of self talk and parallel talk…..and expansion in order to elicit language. Find those activities on the teach me to talk page.
If you are working with a child on the autism spectrum….this activity can be used without any language demands at all…..as you start to pair yourself with an activity that the child truly desires……she should then desire to engage in the activity with you! If you read on my autism spectrum disorders page…you will see that it has been my experience that children on the spectrum…..struggle with spontaneous and functional language….language that is not scripted…language that is used with meaning on a spontaneous level. The other weakness is noted with regard to the child’s desire to be social and engage in an activity with someone else. So with an activity such as the parachute…a Yoga ball…a trampoline….playing row-row-row-your-boat…..or giving your little one an airplane ride on your legs…..all of these activities can be used in a non-verbal way….to elicit social interaction with your little one….and used to help them to desire to be social with you!
Thank you to the K family for allowing me to post these pictures of AK and NK….and also thank to my colleague Nancy for bringing her tunnel to our session. As I stated in a previous post…it is so important to me to co-treat when possible with my colleagues…Nancy is a special education teacher…and also an ABA teacher…she works with NK…he presents with an Autism Spectrum Disorder and I work with AK…he presents with expressive and receptive language delays. Our goal..when we co-treat is to help these twin boys desire to play with one another…to increase their play skills…to improve reciprocity during play…to improve social language…to increase NK’s desire to want to play near (parallel play) AK…to play with AK…and to eventually seek out AK. Often times…children on the spectrum have difficulty with regard to their desire to be social…to have the ability to be social and interact with peers and others…and to have the verbal or non-verbal language to interact with their peers.
What I have learned over the many years working with other ABA therapists is that pairing yourself with a desired object/toy/activity helps children on the spectrum to desire to interact with you….of course the desire may be for the object/toy/or activity….however…if you are able to encourage the little one’s desire to be near or with you because of the activity…the pairing will help to improve the back and forth during play…will help to improve language (whether verbal or non-verbal)…and will help to improve social skills. So Nancy brought her tunnel in…and both boys were or appeared very excited about this activity. Nancy and I then encouraged the two boys to go inside of the tunnel…it was great to see AK saying hi to his brother..and NK making a verbal attempt to say hi to AK….the closeness inside of the tunnel encouraged eye contact between the two boys…and the mesh-netting on the tunnel allowed the boys to peek through and then make eye contact with us!! Great! Next, we handed AK a small ball….and asked him to “give to NK“…he did….NK accepted it…and then we gave one to NK…and asked him to “give to AK“….he did….great to see both of them following this simple direction…great to see the back and forth of just passing a ball to one another…great to see the eye contact they made during this activity…and wonderful to hear the laughter between them.
Simple activities such as this are just amazing for encouraging eye contact and social development. Very little language demands were placed upon the boys…the tunnel is what we used to pair ourselves with the boys…to encourage them to desire to interact with us but more importantly with one another.
Thanks again Nancy! And thanks to the K family!!