Playing, Laughing and Learning with Children on the Autism Spectrum - part 1 potx

Playing, Laughing and Learning with Children on the Autism Spectrum... Sheely ISBN 1 84310 714 7 Caring for a Child with Autism A Practical Guide for Parents Martine Ives and Nell Munro,

Playing, Laughing and Learning with Children on the Autism Spectrum

of related interest

My Social Story Book

Carol Gray and Abbie Leigh White

Illustrated by Sean McAndrew

ISBN 1 85302 950 5

Relationship Development Intervention with Young Children

Social and Emotional Development Activities for Asperger Syndrome, Autism, PDD and NLD

Steven E Gutstein and Rachelle K Sheely

ISBN 1 84310 714 7

Caring for a Child with Autism

A Practical Guide for Parents

Martine Ives and Nell Munro, National Autistic Society

Autism and Play

Jannik Beyer and Lone Gammeltoft

ISBN 1 85302 845 2

Giggle Time – Establishing the Social Connection

A Program to Develop the Communication Skills of Children with Autism

Susan Aud Sonders

ISBN 1 84310 716 3

Playing, Laughing

and Learning with Children

on the Autism Spectrum

A Practical Resource of Play Ideas

for Parents and Carers

Julia Moor

Jessica Kingsley Publishers

London and New York

All rights reserved No part of this publication may be reproduced in any material form (including photocopying or storing it in any medium by electronic means and whether

or not transiently or incidentally to some other use of this publication) without the written permission of the copyright owner except in accordance with the provisions of the Copyright, Designs and Patents Act 1988 or under the terms of a licence issued by the Copyright Licensing Agency Ltd, 90 Tottenham Court Road, London, England W1P 9HE Applications for the copyright owner’s written permission to reproduce any

part of this publication should be addressed to the publisher.

Warning: The doing of an unauthorised act in relation to a copyright work may result

in both a civil claim for damages and criminal prosecution.

The right of Julia Moor to be identified as author of this work has been asserted by her

in accordance with the Copyright, Designs and Patents Act 1988

First published in the United Kingdom in 2002

by Jessica Kingsley Publishers Ltd

116 Pentonville Road London N1 9JB, England

Includes bibliographical references and index.

ISBN 1-84310-060-6 (alk paper)

1 Autistic children Treatment 2 Autism in children Treatment 3 Play therapy 4 Parent and child I Title.

RJ506.A9 M66 2002

6168.92’8982065153 dc21

2002021521

British Library Cataloguing in Publication Data

A CIP catalogue record for this book is available from the British Library

ISBN 1 84310 060 6 Printed and Bound in Great Britain by Athenaeum Press, Gateshead, Tyne and Wear

Why is play so difficult for children with autism?

So what do we actually mean by play?

2 Early Playing Skills: Gaining Attention

What does ‘sharing space’ mean?

The drive to avoid

Why do children on the autism spectrum need structure?

What does structuring play actually mean

and how does it work?

Creating play opportunity – setting the stage

Breaking play down into tasks

Applied Behavioural Analysis (ABA)

Structuring early learning

Individual example: Sam

Structuring the day – creating a visual diary

Introducing choice and flexibility

Help – my child won’t play with his toys!

Reassessing existing toys: back to basics

Being organized

Picture prompts for playing

Getting started: ideas

Individual example: Sally

Sources of toys

What to look for in appropriate toys

Separating toys into challengers and reinforcers

Modifying existing toys to remove stress

The importance of realism

Specific useful toys

Birthdays and Christmas

Saviour and enemy

Ideas to try at home

Finding a collection of enjoyable pieces

Listening and playing to music together

Relaxation

Scripts to rhythm – encouraging speech through song

How does this work in practice? – ideas

Singing spontaneous commentaries

Making your own music

Using your music box

Auditory Integration Training

Theory of mind and social development

Why is turn taking difficult for children on

the autism spectrum?

Awareness of others – practical activities to help

Awareness of others’ thoughts – practical activities to help

Small beginnings – turn-taking with an adult

Turn-taking with peers and siblings

Aids to help turn-taking

Turn-taking in everyday life

Sensory integration problems

Making a tactile box

Imaginative uses for boxes

Human ‘jack in the box’

The benefits of outdoor play

The need for structure

Getting started: games and activities

Big outdoor play equipment

Tunnels, play tents and cubes

Outdoor play in winter weather

10 Water Play 165

Autism and water

Problems and solutions

Individual example: Katherine

Enjoying water play indoors

Bath time play

Table top water play

Outdoor water play

Swimming

Television – why?

Common problems and possible solutions

Many uses for the camcorder

Video modelling

Why art?

The obstacles between art and your child

Gaining attention by being indirect

Getting started

Art ideas

Scissors and glue

Craft

What type of toys?

14 Introducing Books and Reading 219

The problems

Starting out – looking at books together

Individual example: Peter

Individual example: Fay

Ideas

Moving on – reading for meaning

Problems with reading for meaning

Story sequences and consequences

Goals

Observation, timing, preparation

Specific books to try

Popular characters

Tape/book packages

Early literacy

Word recognition

Individual example: Lewis

Activities to develop language understanding

Finally

15 Problems, Frustration and Tantrums – Making

Deal with your own frustration first!

Reducing stress while you play

Flexible parenting for rigid kids!

Re-assessing play skills – the need for goals

Enjoy your child

Resources

To my husband Chris, for his loving support and dedication and for being with me on the journey every step of

the way.

11

was missing a vital part of his childhood and watching his ingless rituals and being constantly shut out were breaking myheart.

mean-For 12 months my main focus had been getting through theday without distress, but I wanted more than this for my son andfelt angry with the autism for robbing him of what I felt was hisbirthright It seemed that so many things were off limits; his world(and mine) was getting smaller and smaller; at an age when curios-ity was meant to urge him forward – to explore, to communicate,

to experience and understand his world – my son simply wanted

to shut it out Frustratingly for me I knew that there was vastpotential; an able, intelligent little boy held hostage by the differ-ent way in which his brain thinks and processes

As someone who likes to feel there is a practical solution toeverything, I decided to haul myself out of the pit of ‘why us?’ and

to really try to understand first, his disorder and second, how he as

an individual expressed his autism Armed with this information I

knew there’d be no miracles but at least I’d be making informedchoices and be doing everything in my power to shorten thedistance between his world and mine On top of this I just felt Ihad to find a constructive way to fill what seemed to be an eternity

of weeks and months with a little boy that simply didn’t want toengage with the planet he was born on I didn’t know him

I began to realize that the direct ‘front door’ approach to action was useless: “look at this”, “Let’s do this” “Come here andsee” – they were cues for him to protest or run off and avoid inter-

inter-action; fight or flight Instinctively I felt there must be other

pathways to access my son, and what I found through trial anderror was that there was indeed a ‘back door’ where I could sneak

in and capture his attention without him even realizing that waswhat I was doing!

14 Playing, Laughing and Learning with Children on the Autism Spectrum

Gradually over two years we built up a repertoire of play, ferring similar indirect techniques from one activity to the next,building on success and learning from failure I discovered how toimprove communication, how to structure not only the day as aseries of activities but activities as a series of tasks I also found Icould punctuate the day with short bursts of direct learning toler-ated by the prospect of a variety of motivational strategies.

trans-It dawned on me through talking to and reading about otherparents that they too had similar methods After surveying ahundred such parents it became apparent that there were ideas outthere but that there was also desperation for more Our childrenare very individual; they deal with their autism in unique ways andare affected to different degrees with varying associated learningdifficulties Yet there are so many common threads: a need forroutine and visual cues, problems with sensory overload, and anatural motivation to avoid anything outside the repertoire offamiliarity

Four years ago I needed a book of ideas; something that related

to my son’s specific collection of problems Everything I assumedabout parenting – providing love, attention and a stimulatingenvironment – was rewritten by his diagnosis It stripped me of myconfidence as a mum I questioned common sense because eventhat often didn’t work Yet this book is about common sense.Mums and dads are in a prime position to help their children reachtheir fullest potential Parents come armed with unconditionallove, an unsurpassed knowledge of their individual child and themotivation and commitment to do ‘whatever it takes’ I hope thisbook will not only provide you with a collection of useful ideasbut will help you find a way of playing with your child thatrebuilds confidence and relationships The ideas are there to dip inand try Some may work, some may not – they do not constitute atask list that has to be ticked off and worked through! Choose

those that you feel your child is ready to tackle, and that you are

confident trying; leave the rest for weeks, months or even yearslater

Our children’s development doesn’t correspond to a set of agesand stages and as such there are no age guidelines Keep movingforward by carefully monitoring what your child is capable of andready to tackle next – but don’t rush, push or pitch your expecta-tions in advance of his ability More fundamentally, the point is to

illustrate that by really observing and understanding your child you

can learn to tune into his most receptive moments, to tailor theenvironment to increase these opportunities and to interact withhim in a manner that prolongs them

So what qualifies me to put these ideas together? It isn’t myrecent degree in psychology or my eight years working withadults with learning disabilities (many of whom have autism); it isbeing a mum to a little boy who has challenged me all his waking(and sleeping!) hours, day in and day out, to understand the wayhis brain works and the way he as an individual thinks, and to usethis information to help him play, both independently, and toengage with me in a variety of shared activities I would not dare toportray myself as an expert on autism, but living with and loving achild with autism is an incredible journey of learning andre-evaluating what we expect from parenthood As parents weoften feel helpless when our children are first diagnosed – yet asparents we are in the best possible position to help

Please note that the individual examples in the book are trations based on the types of experience reported back to me inthe surveys and on my own experience I’ve used the male genderthroughout – this is simply to make reading easier and less formal.Throughout the book there are several comparisons to

illus-‘non-autistic’ children I prefer this term to the ambiguous word

‘normal’

16 Playing, Laughing and Learning with Children on the Autism Spectrum

• test how material objects work and how actions canchange outcomes, for example ‘If I lift this ramp up, thetoy car slides down’ or ‘What happens if I pour waterfrom this beaker into this little cup?’

• try out frightening ideas safely, for example ‘The badwolf is hiding and he’s going to get me if I make anoise…’

• work out the relations between people and how tobehave and what to expect in certain situations, forexample playing doctors, families, teachers

• express imagination and creativity through music,

dancing, drawing, playdough etc., giving the child asense of esteem and pride in his achievements

• re-enact everyday situations using toys and apply

different storylines and consequences for example

‘Mummy and little girl are out walking, oh no little girlhas fallen…lets get a plaster…’ or ‘…call an

ambulance…’or ‘… kiss it better…’ etc

This list of why play is important is not definitive and obviouslythe child is completely unaware as to why he is playing – he justwants to Instinctively he is motivated to initiate interaction withpeople and with his environment, and the nice feeling he getsfrom doing it stimulates him to keep doing it

Why is play so difficult for children with autism?

First look at the problems common (in varying degrees) to all

children on the autism spectrum:

• Language problems both in expressing and

understanding the content of speech

18 Playing, Laughing and Learning with Children on the Autism Spectrum

• Problems with social interaction – an unwillingness to

allow others to share experiences, a lack of

understanding of the thoughts and feelings and

intentions of others and a general problem with theinterpretation of non-verbal cues: facial expressions,tone of voice etc

• Problems of imagination – difficulty in grasping the

meaning of imaginary situations, often leading to

repetitive, obsessive actions that only mean something

to the child himself

Given that each of the above is an essential ingredient that allowschildren to play, it’s no wonder the child with autism feels lost andconfused and resorts to activities that are meaningful and comfort-ing only to him, even if they are repetitive and inappropriate

So what do we actually mean by play?

The first thing that springs to mind when we mention play is theuse of toys This can be misleading – abandon a non-autisticthree-year-old in a room filled with unfamiliar toys and he will flitfrom one to the other, not really knowing what to do with them;

he needs interaction with an adult – to be shown and helped sothat later he can share the experience with another child Oftenthe interaction is more rewarding to the child than the toy itself;

he delights in the adult’s delight at an object In fact the adult’sreactions teach him how to react, which he can then generalize to

a new type of a familiar toy

The key to playing is therefore interaction ‘But this is so

diffi-cult with my youngster’, I hear you say It certainly is, especially ifyour child simply doesn’t understand that communication ‘means’anything The extent and quality of your interactions will differaccording to your individual child’s level of disability but the

Why is Playing So Important? 19

effort (and you will need lots of it!) will be rewarding both to youand your child as you begin to build structures for learning andcommunicating in the future Toys are tools or props to aid inter-action through play, often the minimum or even no props areneeded; a box, a cushion, a ball or you may adapt a game/toy thatyou already have.

Putting these ideas together hopefully illustrates that although

teaching your child how to behave and respond in certain situations

is useful, developing in him a real sense of enjoyment in tion will further motivate him to seek out interaction (probablyagainst the better judgement of his autistic brain) and allow him tosocially develop to the best of his potential

interac-Using this book

Try to read Chapters 2, 3 and 4 to start off with These chapterslook at the general principles of using indirect non-confron-tational play approaches with short bursts of structured directedplay They give you ideas of how to set about finding differentpathways to access your child’s attention and how to create oppor-tunities for him to interact and communicate, as well as tacklingthe practicalities of using and organizing the play equipment youalready have The rest of the chapters look at specific areas of playand are filled with practical ideas for how to approach them andmaximise interaction opportunities and learning potential Not allthe play ideas will be appropriate for your child Some are pitched

at ‘difficult to reach’ children who may have additional learningdifficulties; others are suitable for verbal, able children needing

on-going activities Choose those suited to your child and the areas

that you feel need to be worked on

20 Playing, Laughing and Learning with Children on the Autism Spectrum