UNIT 7- 2, SECTION 2 – OTHER THERAPIES (Continued); CAMs (RDI, SIT/SPD, ST, TEAACH)
NOTE: PROCEED WITH CAUTION. Complementary and Alternative Medicine (CAMs) treatments are still very controversial and may even be very dangerous. Before starting any treatment program, investigate thoroughly, and ALWAYS, ALWAYS talk to your child’s doctor first.
PLEASE READ DISCLAIMERS –
The following THERAPIES & CAMs (RDI, SIT/SPD, ST, TEAACH) without intent or suggestion of status or effectiveness.
The next 4 programs (RDI, SIT/SPD, ST, TEAACH):
NOTE: PROCEED WITH CAUTION. Complementary and Alternative Medicine (CAMs) treatments are still very controversial and may even be very dangerous. Before starting any treatment program, investigate thoroughly, and ALWAYS, ALWAYS talk to your child’s doctor first.
PLEASE READ DISCLAIMERS –
The following THERAPIES & CAMs (RDI, SIT/SPD, ST, TEAACH) without intent or suggestion of status or effectiveness.
The next 4 programs (RDI, SIT/SPD, ST, TEAACH):
1. Relationship Development Intervention (RDI)
Relationship Development Intervention® (RDI) was developed by psychologist Steven Gutstein, Ph.D. (2019), a family-based, behavioral treatment designed to address autism’s core symptoms. (RDI) builds on one’s ‘dynamic intelligence’, defined as the ability to think flexibly. Including integrating different incoming sensory information, appreciating different perspectives, and coping with change.
RDI’s six objectives are:
· Emotional referencing: The ability to learn from the emotional and subjective experiences of others.
Retrieved online from – https://www.stanleygreenspan.com/
RDI is a model which teaches parents how to guide their child in a reciprocal relationship. Most families spend 2 ½ hours daily participating and making meaningful changes to their lives. RDI takes place in the family’s unique cultural home setting and usually lasts for an initial period of 30+ weeks.
This ‘relationship focused’ process addresses the key core autism issues of motivation, communication, self-awareness, and flexible thinking. According to Mahoney & Perales (2003), parents are taught to enhance their use of responsive interactive strategies, during routine interactions with their children.
This study showed that RDI helped over 200 children diagnosed with autism. Children with mild & moderate delays, and/or children ‘at-risk’ due to prematurity or poor environmental conditions. RDI also took into account the child’s temperament, when teaching parents how to respond to everyday events. Some parents reported that they liked learning new strategies which helped them build a relationship with their child, while dealing with challenging behaviors. Other parents felt that making them the ‘therapist’ so to speak, added too much stress to an already stressful life. (Know that siblings can learn this process too.)
< My Thoughts > “ …making them the ‘therapist’…”
RDI is a ‘relationship focused’ process, therefore the parents do become the therapists, in a sense. But, learning new strategies, recognizing what is going on, understanding what needs to take place, in order to ‘break the circuit’ of terror, and restore calm is very important to the parent / child relationship.
Decker (2011) declares – when I am in the store and my child suddenly rolls into tantrum mode, kicking and screaming and such, it’s not very helpful if a passerby says things like, “He needs is a good spanking,” or “You wouldn’t see my kid acting like that.” I want to say, “Go ahead and hit him, see if it works.” Or, “Bye, honey. This nice man is ‘gonna’ take you home. Have fun.”
Okay, so I don’t actually do this. But I really, really want to.
But, this particular day, as I proceeded to make my way out of Rite Aid. Jaxson pummeled me from behind, sinking his teeth into my arm. My purchases fell from the plastic bag, trailing behind me like Hansel and Gretel’s breadcrumbs.
Then, the angel appeared. Without asking, without my silent pleading eyes meeting hers, she quietly followed me to the parking lot, picking up my prescriptions, hair spray, box of tampons, and a bag of Hershey’s kisses. Gathering them all up as I maneuvered to press Jaxson against the car with my body, fishing for my keys.
It took ten minutes to unlock the door and push my screaming child inside. I closed the door and stood there for a moment, taking a look at the nice bruise on my arm that was already forming, his little teeth ‘imprints’ clearly in the center. She handed me the bag and smiled as Jaxson wailed inside, banging on the window; his voice only slightly muffled by the closed windows.
“He’s autistic,” was the only thing I could think of saying. “Yeah, I kind of guessed there was something going on there besides the regular old tantrum. Can you get home okay?” she asked. My eyes filled with tears. “Yes, thanks. You have no idea how nice it is to have someone not judging me right now.” “I think I can guess,” she smiled and then left for her car. That day, I met an angel at the Rite Aid drugstore.
< My Thoughts > “…You have no idea…”
“You have no idea how nice it is to have someone not judging me right now.” A public thank you to all of our friends and family who have ‘not judged’ our loving decision to adopt our Sonny, nor questioned our other decisions regarding him.
The parents in Hoogsteen & Woodgate (2013) felt that their community members were unaware and uneducated about the challenge they faced when bringing their child with them, when they shopped, or visited in the community. Such as when the negative characteristics of autism were displayed – tantrums, yelling, disruptive behavior, meltdowns, screaming, physical violence towards themselves and others.
People look at you and they just think he’s a bad kid, because he looks normal. Or, what they think they see is bad parenting, of a bad and uncontrollable child. But most of all, it’s a rude disruption to their shopping experience.
< My Thoughts > “…the negative characteristics of autism…”
RDI is advertised to be a ‘behavioral’ treatment, designed to address autism’s core symptoms; the negative characteristics of autism. I don’t have chapters which specifically deal with, or are titled ‘Behavior’. My reason for this is because I feel that ‘Behavior’ is usually a ‘response’ to something going on in the child’s world; good or bad; positive or negative. As a wise person once said, “He’s not giving you a ‘bad time’, he’s having a ‘bad time’.”
Whiffen (2009) tells how she learned about RDI – I received an email from my Yahoo! Group regarding this new treatment called RDI. At first, I blew it off as being the’ new treatment choice of the month’, but as I started researching it further, I was really impressed with how it addresses the core deficits of autism.
I recently finished reading the book Relationship Developmental Intervention (RDI) with Young Children by Steven Gutstein. This new way of teaching our kids really makes sense.
There are additional activities you can add to reinforce the basics. RDI helps children learn nonverbal communication, social referencing, and ways to be more vigilant in their environment. I want Clay not only to be able to function in real life, but also to have relationships and friends. Isn’t that really what life is all about? We need each other to enhance our quality of life.
At our next team meeting, I posed a question – “What are Clay’s deficits?”
“It seems Clay still has a hard time with attention span, focusing, and impulsivity,” one member says.
Another adds, “He also doesn’t seem to contribute when in group activities, unless he’s specifically asked, or singled out.”
“I think RDI will help with all of these issues,” I say. “Now we know what we need him to work on. I think RDI will fill in the holes we are seeing.”
The RDI activities dovetail our existing program by reinforcing what we are already teaching him. But they also emphasize ‘experience sharing’ in a relationship, by teaching him inhibitory control; by stopping when I stop, starting when I start.
Everyone is amazed at how his language and expressions have really blossomed over the last six months. Still, I need to know exactly how he is doing in terms of IQ, social skills, and language. I want him evaluated by a professional; someone who doesn’t know him.
< My Thoughts > “…I need to know…”
Knowing how a child is doing, as they progress through a therapy, should not be assumed. When choosing a therapy, determine what kinds of data, and tracking they will provide; as your child moves through the phases of the program. It’s also an important part of distinguishing your child from their autism.
REFERENCES: UNIT 7- 2 Who May Help? OTHER THERAPIES Section 2;
1. Relationship Development Intervention (RDI)
Decker, J. (2011). I Wish I Were Engulfed in Flames: My Insane Life Raising Two Boys with Autism; eBooks 2011 Edition.
Gutstein, S. & Greenspan, S. (2019). Relationship Development Intervention® (RDI); Retrieved online from – https://www.stanleygreenspan.com/
Hoogsteen, L. & Woodgate, R. (2013).The Lived Experience of Parenting a Child With Autism in a Rural Area: Making the Invisible, Visible; Pediatric Nursing; V39:5.
Mahoney, G., Perales, F. (2003). Using Relationship-Focused Intervention to Enhance the Social-emotional Functioning of Young Children with Autism Spectrum Disorders; Topics in Early Childhood Special Education; V23:2, p77-89.
Whiffen, L. (2009). A Child’s Journey Out of Autism: One Family’s Story of Living in Hope and Finding a Cure; eBook Edition.
UNIT 7- 2 CAMS WHO MAY HELP? OTHER THERAPIES - Section 2 (Continued).
Relationship Development Intervention® (RDI) was developed by psychologist Steven Gutstein, Ph.D. (2019), a family-based, behavioral treatment designed to address autism’s core symptoms. (RDI) builds on one’s ‘dynamic intelligence’, defined as the ability to think flexibly. Including integrating different incoming sensory information, appreciating different perspectives, and coping with change.
RDI’s six objectives are:
· Emotional referencing: The ability to learn from the emotional and subjective experiences of others.
- Social coordination: The ability to observe and control behavior to successfully participate in social relationships.
- Declarative language: The ability to use language and non-verbal communication to express curiosity, invite interactions, share perceptions and feelings, and coordinate with others.
- Flexible thinking: The ability to adapt and alter plans as circumstances change.
- Relational information processing: The ability to put things into context and solve problems that lack clear cut solutions.
- Foresight and hindsight: The ability to anticipate future possibilities based on past experiences.
Retrieved online from – https://www.stanleygreenspan.com/
RDI is a model which teaches parents how to guide their child in a reciprocal relationship. Most families spend 2 ½ hours daily participating and making meaningful changes to their lives. RDI takes place in the family’s unique cultural home setting and usually lasts for an initial period of 30+ weeks.
This ‘relationship focused’ process addresses the key core autism issues of motivation, communication, self-awareness, and flexible thinking. According to Mahoney & Perales (2003), parents are taught to enhance their use of responsive interactive strategies, during routine interactions with their children.
This study showed that RDI helped over 200 children diagnosed with autism. Children with mild & moderate delays, and/or children ‘at-risk’ due to prematurity or poor environmental conditions. RDI also took into account the child’s temperament, when teaching parents how to respond to everyday events. Some parents reported that they liked learning new strategies which helped them build a relationship with their child, while dealing with challenging behaviors. Other parents felt that making them the ‘therapist’ so to speak, added too much stress to an already stressful life. (Know that siblings can learn this process too.)
< My Thoughts > “ …making them the ‘therapist’…”
RDI is a ‘relationship focused’ process, therefore the parents do become the therapists, in a sense. But, learning new strategies, recognizing what is going on, understanding what needs to take place, in order to ‘break the circuit’ of terror, and restore calm is very important to the parent / child relationship.
Decker (2011) declares – when I am in the store and my child suddenly rolls into tantrum mode, kicking and screaming and such, it’s not very helpful if a passerby says things like, “He needs is a good spanking,” or “You wouldn’t see my kid acting like that.” I want to say, “Go ahead and hit him, see if it works.” Or, “Bye, honey. This nice man is ‘gonna’ take you home. Have fun.”
Okay, so I don’t actually do this. But I really, really want to.
But, this particular day, as I proceeded to make my way out of Rite Aid. Jaxson pummeled me from behind, sinking his teeth into my arm. My purchases fell from the plastic bag, trailing behind me like Hansel and Gretel’s breadcrumbs.
Then, the angel appeared. Without asking, without my silent pleading eyes meeting hers, she quietly followed me to the parking lot, picking up my prescriptions, hair spray, box of tampons, and a bag of Hershey’s kisses. Gathering them all up as I maneuvered to press Jaxson against the car with my body, fishing for my keys.
It took ten minutes to unlock the door and push my screaming child inside. I closed the door and stood there for a moment, taking a look at the nice bruise on my arm that was already forming, his little teeth ‘imprints’ clearly in the center. She handed me the bag and smiled as Jaxson wailed inside, banging on the window; his voice only slightly muffled by the closed windows.
“He’s autistic,” was the only thing I could think of saying. “Yeah, I kind of guessed there was something going on there besides the regular old tantrum. Can you get home okay?” she asked. My eyes filled with tears. “Yes, thanks. You have no idea how nice it is to have someone not judging me right now.” “I think I can guess,” she smiled and then left for her car. That day, I met an angel at the Rite Aid drugstore.
< My Thoughts > “…You have no idea…”
“You have no idea how nice it is to have someone not judging me right now.” A public thank you to all of our friends and family who have ‘not judged’ our loving decision to adopt our Sonny, nor questioned our other decisions regarding him.
The parents in Hoogsteen & Woodgate (2013) felt that their community members were unaware and uneducated about the challenge they faced when bringing their child with them, when they shopped, or visited in the community. Such as when the negative characteristics of autism were displayed – tantrums, yelling, disruptive behavior, meltdowns, screaming, physical violence towards themselves and others.
People look at you and they just think he’s a bad kid, because he looks normal. Or, what they think they see is bad parenting, of a bad and uncontrollable child. But most of all, it’s a rude disruption to their shopping experience.
< My Thoughts > “…the negative characteristics of autism…”
RDI is advertised to be a ‘behavioral’ treatment, designed to address autism’s core symptoms; the negative characteristics of autism. I don’t have chapters which specifically deal with, or are titled ‘Behavior’. My reason for this is because I feel that ‘Behavior’ is usually a ‘response’ to something going on in the child’s world; good or bad; positive or negative. As a wise person once said, “He’s not giving you a ‘bad time’, he’s having a ‘bad time’.”
Whiffen (2009) tells how she learned about RDI – I received an email from my Yahoo! Group regarding this new treatment called RDI. At first, I blew it off as being the’ new treatment choice of the month’, but as I started researching it further, I was really impressed with how it addresses the core deficits of autism.
I recently finished reading the book Relationship Developmental Intervention (RDI) with Young Children by Steven Gutstein. This new way of teaching our kids really makes sense.
There are additional activities you can add to reinforce the basics. RDI helps children learn nonverbal communication, social referencing, and ways to be more vigilant in their environment. I want Clay not only to be able to function in real life, but also to have relationships and friends. Isn’t that really what life is all about? We need each other to enhance our quality of life.
At our next team meeting, I posed a question – “What are Clay’s deficits?”
“It seems Clay still has a hard time with attention span, focusing, and impulsivity,” one member says.
Another adds, “He also doesn’t seem to contribute when in group activities, unless he’s specifically asked, or singled out.”
“I think RDI will help with all of these issues,” I say. “Now we know what we need him to work on. I think RDI will fill in the holes we are seeing.”
The RDI activities dovetail our existing program by reinforcing what we are already teaching him. But they also emphasize ‘experience sharing’ in a relationship, by teaching him inhibitory control; by stopping when I stop, starting when I start.
Everyone is amazed at how his language and expressions have really blossomed over the last six months. Still, I need to know exactly how he is doing in terms of IQ, social skills, and language. I want him evaluated by a professional; someone who doesn’t know him.
< My Thoughts > “…I need to know…”
Knowing how a child is doing, as they progress through a therapy, should not be assumed. When choosing a therapy, determine what kinds of data, and tracking they will provide; as your child moves through the phases of the program. It’s also an important part of distinguishing your child from their autism.
REFERENCES: UNIT 7- 2 Who May Help? OTHER THERAPIES Section 2;
1. Relationship Development Intervention (RDI)
Decker, J. (2011). I Wish I Were Engulfed in Flames: My Insane Life Raising Two Boys with Autism; eBooks 2011 Edition.
Gutstein, S. & Greenspan, S. (2019). Relationship Development Intervention® (RDI); Retrieved online from – https://www.stanleygreenspan.com/
Hoogsteen, L. & Woodgate, R. (2013).The Lived Experience of Parenting a Child With Autism in a Rural Area: Making the Invisible, Visible; Pediatric Nursing; V39:5.
Mahoney, G., Perales, F. (2003). Using Relationship-Focused Intervention to Enhance the Social-emotional Functioning of Young Children with Autism Spectrum Disorders; Topics in Early Childhood Special Education; V23:2, p77-89.
Whiffen, L. (2009). A Child’s Journey Out of Autism: One Family’s Story of Living in Hope and Finding a Cure; eBook Edition.
UNIT 7- 2 CAMS WHO MAY HELP? OTHER THERAPIES - Section 2 (Continued).
2. Sensory Integration Therapy (SIT) for Sensory Processing Disorder (SPD)
One of the most popular intervention therapies for children with autism spectrum disorders (ASD) lacks scientific support, according to review of literature. But several previous surveys indicate SIT remains one of the most common intervention choices; with 99 percent of interviewed occupational therapists using it.
Sensory Integration Therapy (SIT) is designed to offer specific forms of sensory stimuli in the appropriate amounts, with the aim of improving how the nervous system processes sensory stimuli. Therapists who use SIT may have a child with ASD wear a weighted vest, swing, sit on a bouncy ball, or be compressed between pillows.
Rudy (2019) remarks that sensory issues became an official part of the diagnosis, described as: "Hyper- or hypo-reactivity to sensory input or unusual interests in sensory aspects of the environment (e.g., apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement)."
Sensory processing disorder can be disabling because it interferes with so many ordinary activities of daily life. A relatively new technique, sensory integration therapy (SIT), was developed to help people with and without autism to lower their reactivity and improve their ability to participate in a wide range of activities
People who have this dysfunction don’t experience these interactions in the same way. SPD affects the way their brains interpret the information that comes in and how they respond with the emotional, motor, and other reactions.
And, according to the American Academy of Pediatrics, Sensory Integration Therapy (SIT) helps the person deal with sensory information, like sights, sounds, and smells.
According to Bogdashina & Casanova (2016), recent research has provided evidence for the sensory theory of autism and the possibility of diagnosing autism in very young children, if the ‘sensory symptoms’ are taken into account. Research evidence indicates that sensory perceptual differences may be among the first signs of autism in young children.
For example, behaviors such as rocking and rhythmic head banging, spinning objects or perimeter hugging (especially in large spaces), and the need to touch everything in a room before settling down, are typical for both autistic children and those with visual impairments.
Lydon, et al. (2017) let us know that if other interventions, has learning disabilities, then sensory integration therapy (SIT) behavior may be the answer.
< My Thoughts > “…may be the answer.”
The level of individualization required by this program may make SIT a consideration. Or, if you are to the point where you want to do something, even if you’re not sure, then you may want to try a short session; or perhaps request a ‘sensory profile’ for your child. But first be aware that the goal for most parents is to improve their child’s quality of life.
3. Speech Therapy (ST) aka Speech & Language Therapy (SLT)
Speech therapy helps to improve the person’s communication skills. These therapists are usually Speech and Language Pathologists. Some people with autism are able to learn verbal communication skills. For those who are non-verbal/non-vocal, using signing gestures, picture boards, electronic ‘talkers’, rhythmic songs, and/or lip and tongue exercises may work. The speech therapist starts with any oral-motor difficulty the child may have. Therapists work on the child’s expressive language, trying to bring it equal to his or her cognitive/receptive level. In other words, your child may understand more than can be expressed with their current language skills.
Hsieh, et al. (2018) Speech-Language Pathologists (SLPs) conduct communication programs, according to the needs of the clients, and according to their training. They are usually members of the well-known American Speech & Hearing Association (ASHA). They provide high quality treatments to effect sustainable changes related to their client’s needs. They can be expected to be trained in the employment of intensive behavioral techniques; guided by the delivery of Evidence Based Practices (EBP).
Besides fostering language development, a SPL specializes in the instruction of social communication, and a wide range of needs; including consideration of the ethnic and cultural orientation and influences of the family. SLPs often become part of the ‘intervention team,’ as part of an ‘interprofessional’ approach working with children and adults with autism.
Cariello (2015) conveys that even though I knew that Jack could hear someone open a bag of animal crackers from three rooms away, I fostered a tiny seed of foolish hope that maybe, just maybe, he was hearing impaired. Maybe all of this could be solved with a simple crash course in sign language. Nope, not deaf.
So, by the time Jack was sixteen months, we had a speech therapist and a special education teacher working with him weekly. We wanted to have him tested to figure out the source of his language delay.
< My Thoughts > “…we had a speech therapist…”
Parents of non-verbal children often ask me, “Why spend time with a speech therapist when he can’t talk?” Speech and Language therapists work on so many other forms of communication, plus social skills. For example, when playing a simple game, the therapist teaches ‘joint attention’ through turn-taking, waiting for the child to ‘initiate’ the next move. They teach and praise when a child shows patience in ‘anticipation’ of what is going to happen next. Getting a sense of whether or not the child can ‘predict’ what others are thinking or going to do, is important for ‘social communication’.
A speech therapist conducts a series of formal, or informal assessments of the child’s ‘receptive & expressive’ language. ‘Receptive’ language is basically recognizing the words they are hearing. While ‘expressive’ language is being able to say the ‘words’ which they need to express themselves.
A child with autism is usually self-centered and not connected enough to another person to ‘anticipate’ what they are going to do or say. They may not even care. But those who can verbalize say that they ‘do care’, they just get so overwhelmed by all the stimuli around them that it’s easier if they withdraw into themselves, instead. Skilled speech/language specialists may help here.
Squaresky (2014) says it remained for us to explore the system and find appropriate ways to help Greg. I now had to count on others.
Speech therapy brought little change, as the most I heard Greg mutter during each session was one word. Generally, he repeated what Laura said; a phenomenon known as ‘echolalia’. I wanted conversation. Two words, three words; a sentence, maybe?
The slowness and expense of speech class frustrated me. Greg enjoyed playing with our therapist. Laura and was ecstatic when she and Greg interacted. Not me. Jay and I already played with Greg at home. At seventy dollars per hour, I expected Greg to talk.
< My Thoughts > “…Greg enjoyed playing with our therapist…”
Encouraging a child with autism to leave their world long enough to ‘interact’ with others (especially when not a family member), even momentarily, is a huge accomplishment. Then if you can repeat that moment, again; or, something similar the next day, that is a quantum leap forward. That represents a necessary step towards ‘social communication’.
We want our children with autism to do ‘more’ than use communication to ask for food or toys. We want them to socially communicate with us. For instance, when the therapist has a child successfully and appropriately interact with them, while playing a board game, that is a learned and desirable ‘social’ interaction. An ‘in the moment’ interface, which includes acknowledging and contemplating another’s actions; plus a back-and-forth connection’ which is the goal. But all in all, I can relate to Jay and Martha’s frustration.
Cohen (2011) candidly says reveals that Ezra is almost two years old, he still isn’t consistent with sign language and he has no words, so I think about pursuing outside opinions. I call Early Intervention first, a state program that is mandated by federal law.
“What sorts of things are you concerned about?” the coordinator asks me on the phone. “I’m not concerned,” I say. I’m aware I’m pacing as we talk. “But I know he’s supposed to have a few words by now, and I figure speech therapy could help.”
“So, he isn’t talking yet. How old is he, again?”, she asks. I tell her, not wanting to, “He’s twenty-one months.” “Any other concerns?” she continues.
Yes, I’m thinking. His poor eating. No pointing. Crying when songs end. He cries in terrible despair if someone ‘stops’ singing one of his favorite songs.
“No,” I say. “No. Just the words.” We set a date and time, and I immediately start to dread the upcoming appointment. In moments, I am stricken with instinctual fear. What have I done?
< My Thoughts > “Crying when songs end.”
Our Sonny cannot tolerate when something ends, whether it’s a song or a DVD. So, we make every effort to keep his favorites available on a ‘loop’. Somehow in the same vein, the ‘Sonny Ending/Empty – Time to Panic’ category, are empty glasses, empty cups, empty food dishes, and empty cereal boxes. This ‘terrified’ behavior has lessened over the years. Apparently, he finally trusts us to refill and replenish all the ‘empties’, before the disappearance or ‘endings’ become too crushing for him.
Lee & Hyun (2015) share that in the language therapy field, video and audio content are used as teaching media; as well as communication-assisting technology. An Augmentative and Alternative Communication System (AAC) allows users to have virtual peers and avatars to encourage learning, listening to others; including turn-taking and other social skills connected to language.
Now, added to this, is an intelligent robot with an evolved capability for entertainment while providing direct interaction with learners. Besides conversational language, Special Friend iRobiQ has a conversational function which can be delivered in a ‘script approach method’. A hand washing script would start – “Turn on the water”…”Wash hands with soap”… ”Wash hands with water”… ”Wipe hands on towel”… This can be paused or repeated as necessary.
This also helps therapists and parents because it has an added feature of collecting data and compiling reports. Another reason that therapists find this program useful is that this intelligent robot seems like a toy to the participant, and is conversationally predictive. Special Friend iRobiQ is not intimidating and has a capacity for direct interaction, without the human emotions, attitudes, facial expressions. Nor, does it have all sorts of subtle ‘human’ information, which may become confusing to the child.
Sicile-Kira (2014) tells us that there are many ‘apps’ that have been developed for tablets and smartphones; such as the iPad and iPhone. Augmentative/Alternative Communication (AAC) devices are costly, but they may be covered by insurance. Augmentative devices are used mostly to supplement speech; while Alternative devices are used when there is little or no speech. Find out which may be recommended for your child. Treatment for particular symptoms, such as speech therapy for language delays, often does not need to wait for a formal ASD diagnosis. While early intervention is extremely important, intervention at any age can be helpful. For information on these devices go online to https://www.asha.org/public/speech/disorders/AAC/
REFERENCES: UNIT 7-2 WHO MAY HELP? OTHER THERAPIES; CAMS Section 2
2. Sensory Integration Therapy (SIT) & 3. Speech Therapy (ST)
Bogdashina, O. & Casanova (2016). Sensory Perceptual Issues in Autism and Asperger Syndrome, Different Sensory Experiences – Different Perceptual Worlds; Second Edition: London; Philadelphia: Jessica Kingsley Publishers.
Cariello, C. (2015). What Color is Monday? How Autism Changed One Family for the Better; eBook Edition.
Cohen, K. (2011). Seeing Ezra: A Mother’s Story of Autism, Unconditional Love, and the Meaning of Normal; eBook 2011 Edition.
Hsieh, M., Lynch, G., et al. (2018). Intervention Techniques Used with Autism Spectrum Disorder by Speech-Language Pathologists in the United States and Taiwah: A Descriptive Analysis of Practice in Clinical Settings; American Journal of Speech-Language Pathology; V27, p1091-1104.
Lee, H. & Hyun, E. (2015). The Intelligent Robot Contents for Children with Speech-Language Disorder; Educational Technology & Society; V18:3; p100-113.
Lydon, H., Healy, O., et al. (2017). Comparison of Behavioral Intervention & Sensory Integration Therapy on Challenging Behavior of Children with Autism; Behavioral Intervention; V32, p297-310.
Rudy, L. (2019). Sensory Integration Therapy & Autism; Very Well Health, Online Magazine; Retrieved online from –
https://www.verywellhealth.com/sensory-integration-therapy-and-autism-260509/
Sicile-Kira, C. (2014). Autism Spectrum Disorder (revised): The Complete Guide to Understanding Autism; New York, N. Y.: Penguin Random House Company.
Squaresky, M. (2014). A Spot on the Wall; eBook Edition.
Speech therapy helps to improve the person’s communication skills. These therapists are usually Speech and Language Pathologists. Some people with autism are able to learn verbal communication skills. For those who are non-verbal/non-vocal, using signing gestures, picture boards, electronic ‘talkers’, rhythmic songs, and/or lip and tongue exercises may work. The speech therapist starts with any oral-motor difficulty the child may have. Therapists work on the child’s expressive language, trying to bring it equal to his or her cognitive/receptive level. In other words, your child may understand more than can be expressed with their current language skills.
Hsieh, et al. (2018) Speech-Language Pathologists (SLPs) conduct communication programs, according to the needs of the clients, and according to their training. They are usually members of the well-known American Speech & Hearing Association (ASHA). They provide high quality treatments to effect sustainable changes related to their client’s needs. They can be expected to be trained in the employment of intensive behavioral techniques; guided by the delivery of Evidence Based Practices (EBP).
Besides fostering language development, a SPL specializes in the instruction of social communication, and a wide range of needs; including consideration of the ethnic and cultural orientation and influences of the family. SLPs often become part of the ‘intervention team,’ as part of an ‘interprofessional’ approach working with children and adults with autism.
Cariello (2015) conveys that even though I knew that Jack could hear someone open a bag of animal crackers from three rooms away, I fostered a tiny seed of foolish hope that maybe, just maybe, he was hearing impaired. Maybe all of this could be solved with a simple crash course in sign language. Nope, not deaf.
So, by the time Jack was sixteen months, we had a speech therapist and a special education teacher working with him weekly. We wanted to have him tested to figure out the source of his language delay.
< My Thoughts > “…we had a speech therapist…”
Parents of non-verbal children often ask me, “Why spend time with a speech therapist when he can’t talk?” Speech and Language therapists work on so many other forms of communication, plus social skills. For example, when playing a simple game, the therapist teaches ‘joint attention’ through turn-taking, waiting for the child to ‘initiate’ the next move. They teach and praise when a child shows patience in ‘anticipation’ of what is going to happen next. Getting a sense of whether or not the child can ‘predict’ what others are thinking or going to do, is important for ‘social communication’.
A speech therapist conducts a series of formal, or informal assessments of the child’s ‘receptive & expressive’ language. ‘Receptive’ language is basically recognizing the words they are hearing. While ‘expressive’ language is being able to say the ‘words’ which they need to express themselves.
A child with autism is usually self-centered and not connected enough to another person to ‘anticipate’ what they are going to do or say. They may not even care. But those who can verbalize say that they ‘do care’, they just get so overwhelmed by all the stimuli around them that it’s easier if they withdraw into themselves, instead. Skilled speech/language specialists may help here.
Squaresky (2014) says it remained for us to explore the system and find appropriate ways to help Greg. I now had to count on others.
Speech therapy brought little change, as the most I heard Greg mutter during each session was one word. Generally, he repeated what Laura said; a phenomenon known as ‘echolalia’. I wanted conversation. Two words, three words; a sentence, maybe?
The slowness and expense of speech class frustrated me. Greg enjoyed playing with our therapist. Laura and was ecstatic when she and Greg interacted. Not me. Jay and I already played with Greg at home. At seventy dollars per hour, I expected Greg to talk.
< My Thoughts > “…Greg enjoyed playing with our therapist…”
Encouraging a child with autism to leave their world long enough to ‘interact’ with others (especially when not a family member), even momentarily, is a huge accomplishment. Then if you can repeat that moment, again; or, something similar the next day, that is a quantum leap forward. That represents a necessary step towards ‘social communication’.
We want our children with autism to do ‘more’ than use communication to ask for food or toys. We want them to socially communicate with us. For instance, when the therapist has a child successfully and appropriately interact with them, while playing a board game, that is a learned and desirable ‘social’ interaction. An ‘in the moment’ interface, which includes acknowledging and contemplating another’s actions; plus a back-and-forth connection’ which is the goal. But all in all, I can relate to Jay and Martha’s frustration.
Cohen (2011) candidly says reveals that Ezra is almost two years old, he still isn’t consistent with sign language and he has no words, so I think about pursuing outside opinions. I call Early Intervention first, a state program that is mandated by federal law.
“What sorts of things are you concerned about?” the coordinator asks me on the phone. “I’m not concerned,” I say. I’m aware I’m pacing as we talk. “But I know he’s supposed to have a few words by now, and I figure speech therapy could help.”
“So, he isn’t talking yet. How old is he, again?”, she asks. I tell her, not wanting to, “He’s twenty-one months.” “Any other concerns?” she continues.
Yes, I’m thinking. His poor eating. No pointing. Crying when songs end. He cries in terrible despair if someone ‘stops’ singing one of his favorite songs.
“No,” I say. “No. Just the words.” We set a date and time, and I immediately start to dread the upcoming appointment. In moments, I am stricken with instinctual fear. What have I done?
< My Thoughts > “Crying when songs end.”
Our Sonny cannot tolerate when something ends, whether it’s a song or a DVD. So, we make every effort to keep his favorites available on a ‘loop’. Somehow in the same vein, the ‘Sonny Ending/Empty – Time to Panic’ category, are empty glasses, empty cups, empty food dishes, and empty cereal boxes. This ‘terrified’ behavior has lessened over the years. Apparently, he finally trusts us to refill and replenish all the ‘empties’, before the disappearance or ‘endings’ become too crushing for him.
Lee & Hyun (2015) share that in the language therapy field, video and audio content are used as teaching media; as well as communication-assisting technology. An Augmentative and Alternative Communication System (AAC) allows users to have virtual peers and avatars to encourage learning, listening to others; including turn-taking and other social skills connected to language.
Now, added to this, is an intelligent robot with an evolved capability for entertainment while providing direct interaction with learners. Besides conversational language, Special Friend iRobiQ has a conversational function which can be delivered in a ‘script approach method’. A hand washing script would start – “Turn on the water”…”Wash hands with soap”… ”Wash hands with water”… ”Wipe hands on towel”… This can be paused or repeated as necessary.
This also helps therapists and parents because it has an added feature of collecting data and compiling reports. Another reason that therapists find this program useful is that this intelligent robot seems like a toy to the participant, and is conversationally predictive. Special Friend iRobiQ is not intimidating and has a capacity for direct interaction, without the human emotions, attitudes, facial expressions. Nor, does it have all sorts of subtle ‘human’ information, which may become confusing to the child.
Sicile-Kira (2014) tells us that there are many ‘apps’ that have been developed for tablets and smartphones; such as the iPad and iPhone. Augmentative/Alternative Communication (AAC) devices are costly, but they may be covered by insurance. Augmentative devices are used mostly to supplement speech; while Alternative devices are used when there is little or no speech. Find out which may be recommended for your child. Treatment for particular symptoms, such as speech therapy for language delays, often does not need to wait for a formal ASD diagnosis. While early intervention is extremely important, intervention at any age can be helpful. For information on these devices go online to https://www.asha.org/public/speech/disorders/AAC/
REFERENCES: UNIT 7-2 WHO MAY HELP? OTHER THERAPIES; CAMS Section 2
2. Sensory Integration Therapy (SIT) & 3. Speech Therapy (ST)
Bogdashina, O. & Casanova (2016). Sensory Perceptual Issues in Autism and Asperger Syndrome, Different Sensory Experiences – Different Perceptual Worlds; Second Edition: London; Philadelphia: Jessica Kingsley Publishers.
Cariello, C. (2015). What Color is Monday? How Autism Changed One Family for the Better; eBook Edition.
Cohen, K. (2011). Seeing Ezra: A Mother’s Story of Autism, Unconditional Love, and the Meaning of Normal; eBook 2011 Edition.
Hsieh, M., Lynch, G., et al. (2018). Intervention Techniques Used with Autism Spectrum Disorder by Speech-Language Pathologists in the United States and Taiwah: A Descriptive Analysis of Practice in Clinical Settings; American Journal of Speech-Language Pathology; V27, p1091-1104.
Lee, H. & Hyun, E. (2015). The Intelligent Robot Contents for Children with Speech-Language Disorder; Educational Technology & Society; V18:3; p100-113.
Lydon, H., Healy, O., et al. (2017). Comparison of Behavioral Intervention & Sensory Integration Therapy on Challenging Behavior of Children with Autism; Behavioral Intervention; V32, p297-310.
Rudy, L. (2019). Sensory Integration Therapy & Autism; Very Well Health, Online Magazine; Retrieved online from –
https://www.verywellhealth.com/sensory-integration-therapy-and-autism-260509/
Sicile-Kira, C. (2014). Autism Spectrum Disorder (revised): The Complete Guide to Understanding Autism; New York, N. Y.: Penguin Random House Company.
Squaresky, M. (2014). A Spot on the Wall; eBook Edition.
4. Treatment and Education of Autistic & related Communication-handicapped Children (TEACCH)
Treatment and Education of Autistic & Related Communication-Handicapped Children (TEACCH) uses visual cues to teach skills. For example, picture cards can help teach a child how to get dressed by breaking the information down into small steps. It teaches pro-social behavior for children between 2 – 12 years old. A model designed as a strategy for facilitating language development.
Edelson (2019) expresses that the TEACCH method is successful because it is a ‘therapeutic tool’ to help autistic individuals of all ages, understand their surroundings. This structured teaching method was developed by Professor Eric Schopler and his colleagues at the University of North Carolina at Chapel Hill.
He goes on to say that this step-by-step method addresses the autistic individual’s difficulty with receptive and expressive language, sequential memory, and handling transitions; as well as coping with changes in his or her environment.
TEACCH relies on five basic principles – Physical Structure, Routine, Scheduling, Visual Structure, & Work System.
The TEACCH method helps the autistic person better understand and function in his or her environment through the use of structured physical and visual cueing. The person has constant step-by-step references to guide him or her to navigate their environment.
< My Thoughts > “…use of structured physical and visual cueing…”
TEACCH methods are used by many teachers to get the desired outcome they are looking for, especially when teaching a complex subject or procedure, step-by-step. The structure of a visual schedule, color-coding, numbering steps, sequencing, placing things to do first at eyelevel, helps learners to internalize and generalize new information.
Parts of this method are often used by teacher and parents to get their child through difficult types of learning. The child may not need to be engaged in the whole program, for instance, but can learn to organize by following color-coding. Or, is helped by seeing on a ‘visual schedule’, how a task has a beginning, a middle, and an end.
Mitchell (2017) makes a point about how children often don’t understand how ‘big’ things are accomplished by taking ‘little steps’. Especially to kids like Kyle, ‘routine’ is so important. She relates a story about preschooler Kyle and his dad, Ben.
“When you have autism, the world can be a scary place. It can seem that things come at you from all sides. You’re contending with the sensory issues when every touch, every sound, every light can feel like just too much.”
She continued, “Remember that teacher in the old Charlie Brown movies? The one who went, ‘Wa, wa wa wa wa’, and we had no idea what was said? That’s how it often is for kids with autism. They not only have trouble understanding us, but they have trouble letting us know their immediate wants and needs.”
“And, there’s more. Most of us automatically see patterns and connections in the world, and in our daily lives. Not so with many kids with autism. They have to be directly taught that there are patterns and consistencies, and that you can predict what is going to happen. When you know what to expect, then the world is not quite as scary a place.”
She tried again, “I’ll try to explain. Kyle is a visual learner, rather than an auditory learner. Kyle can take in information he sees much better than what he hears.” “Look around, our classroom runs on routines. These routines are taught using pictures. There are pictures all over the room.”
She told Ben, “Make a list of the things you want Kyle to do in the morning. Leave it on my desk and I’ll try to have some ‘visuals’ ready for you when you pick him up this afternoon. And remember, show him, while you tell him; and, please stop nagging him.”
< My Thoughts > “Visuals…”
Whether or not a part of the TEAACH program, Visual Schedules can support learning, helping to teach self-help and social skills to persons with autism. Several things need to be kept in mind when creating and designing helpful schedules. Some, but not all people are visual learners. Many times, the visual schedule needs to be accompanied by an auditory backup; or, watching and listening to a Smart Phone App.
Also, ‘visuals’ should be age-appropriate and meet the person at their level of understanding. If the person is very ‘literal’, which many with ASD are, then you may need to take actual photos to use on their schedule, instead of graphics. The child may not be able to ‘generalize’; so, make that routine portable, with the ability to use in a different place. In other words, if Kyle is expected to shower at grandma’s on Saturday, that should be explained that he will be able to take his schedule to take there. Have the child help you make their poster, or make ‘power cards’ for each step, instead. Making things easier isn’t always that easy. Sometimes it takes ‘trial & error’.
The next morning, Ben showed Kyle pictures of socks, underwear, pants, and shirts, explaining how he was to get dressed. Ben removed each picture as that job was completed. When Kyle was dressed, Ben announced, “Good job, Kyle.”
Encouraged, they moved on to the bathroom. Again, it worked, with only a minimum of coaching, Kyle looked at the cards to see what was next. Ben tapped the appropriate card to draw his son’s attention back to the task at hand. Eventually, Kyle took the card himself, putting it back in the envelope.”
< My Thoughts > “…putting it back in the envelope.”
This requires a ‘higher level of understanding and skill’. Requiring Kyle to choose, sort, organize, and replace cards in an envelope, may be a bit beyond most children at his age. To have a one-page schedule may be more helpful.
Or our Sonny has a small photo album which fits in his pocket. He prefers actual photos of the items he needs for dressing. We turn each page, pointing to the next step. He seems to like that.
Upon finishing, Ben saw Kyle’s face needed a little more washing. He grabbed the washcloth to get one more spot on the face. Kyle protested.
Ben understood. According to the visual schedule Kyle had already washed his face. Ben reached in the envelope for the appropriate card. Kyle smiled to let Ben know that he needed to show that card first.
Kyle would rather play with his cereal than eat it. Still, they did not end up mad at each other. Instead of nagging on Kyle to get moving, Ben just tapped the appropriate card to draw his son back to the task at hand. It worked!
Stokes (2019) specifies that structured teaching for children with autism during group story time might be a carpet square, or taped-off square, which can provide clear visual cues as to the physical boundaries of that activity. Floor tape can also be used in gym class to indicate to the child with autism, the area in which he should stay to perform certain motor skills; like warm-up exercises. Minimizing visual and auditory distractions, or even painting walls certain colors, and placing rugs or carpet to identify group and individual task areas, may help. Plus, color-coding carpet paths can signify direct routes for making their way to certain ‘learning’ areas.
< My Thoughts > “…group story time…”
Many public preschool and kindergarten classes start students off with such areas, so as to easily orient the child to the classroom routines. “It’s ‘circle time’, go over and sit on the blue rug.”
Wood, et al. (2014) wants us to understand the importance of early therapy. Saying that the severity of ASD symptoms exhibited during childhood predicts the level of adaptive functioning, in later years; as well as improving the prognosis. Developing a treatment can significantly reduce core autism symptoms; especially if rehearsed and/or practiced in a real-world setting.
The severity of the symptoms should be a high priority. Also taken into account, should be possible resistance to intensive interventions. Advised here too, is that services by school therapists might be included in treatment for school age children. Others in the study, may chose to provide outside services. Such as, visits to psychiatrists, psychologists and other community providers who can prescribe appropriate medication to help shape severe behaviors, reduce anxiety, and increase motivation.
Thompson (2007) tells us, “First the family has to truly believe that their child has Autism. That they are not going to snap out of it, or simply outgrow it. Another difficulty for the family may be the unfamiliar ‘autism’ terms and concepts they will encounter. Parents may also have difficulty creating the immediate changes necessary, due to the daily routines and demands of their own lives. An alternative strategy would be to begin with establishing the family’s more structured, day-to-day routines.
< My Thoughts > “Parents may also have difficulty…”
Know what you can and can’t do. Know your child’s strengths and their willingness to accept and make these changes. You will find that there is hope and there is help, as you continue to explore ways to ‘know your child’.
For instance, ABA has been said to teach your child to adapt to the environment, while TEACCH is said to adapt the environment to suit your child. The programs seem to be ‘polar opposites’; therefore, they probably will have conflicting results.
The severity of a child’s behavior, the amount of support, the temperament of the child and parents all contribute to the family becoming isolated or seeking help. Help can come from Programs, Therapies, & other Interventions. Thompson tells us too that intensive home-based therapies require strong family skills and collaboration. That parents are the conduit by which therapists’ efforts are realized.
Even if your child hasn’t been diagnosed yet, s/he may be eligible for Early Intervention Services. The IDEA Law says that children under the age of 3 years old who are at-risk for having developmental delays may be eligible for services.
REFERENCES: UNIT 7-2 WHO MAY HELP? OTHER THERAPIES, CAMS; SECTION 2;
4. (TEACCH)Treatment and Education of Autistic & Related Communication-Handicapped Children
Edelson, S. (2019). Structured Teaching – TheTEACCH Method; Retrieved online from – www.midwayisd.org/cms/lib/
Mitchell, S. (2012). Autism Goes to School: School Daze Series, Book 1; eBook Edition.
Stokes, S. (2019). Structured Teaching Strategies for Supporting Students with Autism?; Retrieved online from – https://www.naset.ort/index.php?id=2758/
Thompson, T. (2012). Making Sense of Autism; Second Edition. Baltimore, Maryland: Brookes Publishing Company.
Wood, J., Fujii, C., et al. (2014). Impact of Cognitive Behavioral Therapy on Observed Autism Symptom Severity During School Recess: A Preliminary Randomized, Controlled Trial; Journal of Autism & Developmental Disorders; V44, p2264-2276.
DISCLAIMER (2024) Know Autism – Know Your Child: with < My Thoughts > by Sara Luker; 2024
Just to let you know that I, Sara Hayden Luker, have put forth my best efforts in presenting what I have learned about autism, by sharing the stories and studies of those who have gone before us. Any author’s mention of products, services, treatments, and interventions or actions are not to be considered an endorsement, thereof. Know that to some, autism is an ‘unregulated business’. The content of this website material, digital or in any other form does not represent medical advice; nor does it constitute medical suggestions in any way. The material, including any downloadable parts, is for informational and/or educational purposes only. Your download and/or use of any of this material indicates your acceptance of this disclaimer.
This is a Personal Use Electronic Download. By downloading, you hereby agree and acknowledge that you are not acquiring any right, title or interest in, or to, the material; nor any associated copyrights, other than the right to possess, hold and use for personal, non-commercial purposes. Furthermore, you agree that you will: (i) not scan, copy, duplicate, distribute or otherwise reproduce the material(s) to resell, (ii) not use the material(s) for any commercial purposes. By purchasing/downloading you agree to these terms unconditionally. No ‘rights’ are given or transferred.
Treatment and Education of Autistic & Related Communication-Handicapped Children (TEACCH) uses visual cues to teach skills. For example, picture cards can help teach a child how to get dressed by breaking the information down into small steps. It teaches pro-social behavior for children between 2 – 12 years old. A model designed as a strategy for facilitating language development.
Edelson (2019) expresses that the TEACCH method is successful because it is a ‘therapeutic tool’ to help autistic individuals of all ages, understand their surroundings. This structured teaching method was developed by Professor Eric Schopler and his colleagues at the University of North Carolina at Chapel Hill.
He goes on to say that this step-by-step method addresses the autistic individual’s difficulty with receptive and expressive language, sequential memory, and handling transitions; as well as coping with changes in his or her environment.
TEACCH relies on five basic principles – Physical Structure, Routine, Scheduling, Visual Structure, & Work System.
- Physical Structure refers to clearly defined step-by-step boundaries for activities like – work, play, snack, music, and transitioning.
- Routine is the most functional skill because it is needed throughout the person’s lifetime. All of the other TEACCH principles lend themselves to support the person’s daily routine.
- Scheduling is a step-by-step planner for the person’s entire day, week, and month. This is printed or recorded schedule provided in words, picture, drawings, or however the person can interpret it best; visual, auditory, and/or kinesthetic.
- Visual Structure refers to visual cues. For instance, the person uses colored containers or dividers to show organizational steps; step-by-step. Each step is detailed on a printed ‘routine’ sheet.
- Work System is set up so the person knows what to expect during a task or activity; step-by-step, following a color-coded routine. The goal is to have the person work independently, in an organized way to complete the task or activity.
The TEACCH method helps the autistic person better understand and function in his or her environment through the use of structured physical and visual cueing. The person has constant step-by-step references to guide him or her to navigate their environment.
< My Thoughts > “…use of structured physical and visual cueing…”
TEACCH methods are used by many teachers to get the desired outcome they are looking for, especially when teaching a complex subject or procedure, step-by-step. The structure of a visual schedule, color-coding, numbering steps, sequencing, placing things to do first at eyelevel, helps learners to internalize and generalize new information.
Parts of this method are often used by teacher and parents to get their child through difficult types of learning. The child may not need to be engaged in the whole program, for instance, but can learn to organize by following color-coding. Or, is helped by seeing on a ‘visual schedule’, how a task has a beginning, a middle, and an end.
Mitchell (2017) makes a point about how children often don’t understand how ‘big’ things are accomplished by taking ‘little steps’. Especially to kids like Kyle, ‘routine’ is so important. She relates a story about preschooler Kyle and his dad, Ben.
“When you have autism, the world can be a scary place. It can seem that things come at you from all sides. You’re contending with the sensory issues when every touch, every sound, every light can feel like just too much.”
She continued, “Remember that teacher in the old Charlie Brown movies? The one who went, ‘Wa, wa wa wa wa’, and we had no idea what was said? That’s how it often is for kids with autism. They not only have trouble understanding us, but they have trouble letting us know their immediate wants and needs.”
“And, there’s more. Most of us automatically see patterns and connections in the world, and in our daily lives. Not so with many kids with autism. They have to be directly taught that there are patterns and consistencies, and that you can predict what is going to happen. When you know what to expect, then the world is not quite as scary a place.”
She tried again, “I’ll try to explain. Kyle is a visual learner, rather than an auditory learner. Kyle can take in information he sees much better than what he hears.” “Look around, our classroom runs on routines. These routines are taught using pictures. There are pictures all over the room.”
She told Ben, “Make a list of the things you want Kyle to do in the morning. Leave it on my desk and I’ll try to have some ‘visuals’ ready for you when you pick him up this afternoon. And remember, show him, while you tell him; and, please stop nagging him.”
< My Thoughts > “Visuals…”
Whether or not a part of the TEAACH program, Visual Schedules can support learning, helping to teach self-help and social skills to persons with autism. Several things need to be kept in mind when creating and designing helpful schedules. Some, but not all people are visual learners. Many times, the visual schedule needs to be accompanied by an auditory backup; or, watching and listening to a Smart Phone App.
Also, ‘visuals’ should be age-appropriate and meet the person at their level of understanding. If the person is very ‘literal’, which many with ASD are, then you may need to take actual photos to use on their schedule, instead of graphics. The child may not be able to ‘generalize’; so, make that routine portable, with the ability to use in a different place. In other words, if Kyle is expected to shower at grandma’s on Saturday, that should be explained that he will be able to take his schedule to take there. Have the child help you make their poster, or make ‘power cards’ for each step, instead. Making things easier isn’t always that easy. Sometimes it takes ‘trial & error’.
The next morning, Ben showed Kyle pictures of socks, underwear, pants, and shirts, explaining how he was to get dressed. Ben removed each picture as that job was completed. When Kyle was dressed, Ben announced, “Good job, Kyle.”
Encouraged, they moved on to the bathroom. Again, it worked, with only a minimum of coaching, Kyle looked at the cards to see what was next. Ben tapped the appropriate card to draw his son’s attention back to the task at hand. Eventually, Kyle took the card himself, putting it back in the envelope.”
< My Thoughts > “…putting it back in the envelope.”
This requires a ‘higher level of understanding and skill’. Requiring Kyle to choose, sort, organize, and replace cards in an envelope, may be a bit beyond most children at his age. To have a one-page schedule may be more helpful.
Or our Sonny has a small photo album which fits in his pocket. He prefers actual photos of the items he needs for dressing. We turn each page, pointing to the next step. He seems to like that.
Upon finishing, Ben saw Kyle’s face needed a little more washing. He grabbed the washcloth to get one more spot on the face. Kyle protested.
Ben understood. According to the visual schedule Kyle had already washed his face. Ben reached in the envelope for the appropriate card. Kyle smiled to let Ben know that he needed to show that card first.
Kyle would rather play with his cereal than eat it. Still, they did not end up mad at each other. Instead of nagging on Kyle to get moving, Ben just tapped the appropriate card to draw his son back to the task at hand. It worked!
Stokes (2019) specifies that structured teaching for children with autism during group story time might be a carpet square, or taped-off square, which can provide clear visual cues as to the physical boundaries of that activity. Floor tape can also be used in gym class to indicate to the child with autism, the area in which he should stay to perform certain motor skills; like warm-up exercises. Minimizing visual and auditory distractions, or even painting walls certain colors, and placing rugs or carpet to identify group and individual task areas, may help. Plus, color-coding carpet paths can signify direct routes for making their way to certain ‘learning’ areas.
< My Thoughts > “…group story time…”
Many public preschool and kindergarten classes start students off with such areas, so as to easily orient the child to the classroom routines. “It’s ‘circle time’, go over and sit on the blue rug.”
Wood, et al. (2014) wants us to understand the importance of early therapy. Saying that the severity of ASD symptoms exhibited during childhood predicts the level of adaptive functioning, in later years; as well as improving the prognosis. Developing a treatment can significantly reduce core autism symptoms; especially if rehearsed and/or practiced in a real-world setting.
The severity of the symptoms should be a high priority. Also taken into account, should be possible resistance to intensive interventions. Advised here too, is that services by school therapists might be included in treatment for school age children. Others in the study, may chose to provide outside services. Such as, visits to psychiatrists, psychologists and other community providers who can prescribe appropriate medication to help shape severe behaviors, reduce anxiety, and increase motivation.
Thompson (2007) tells us, “First the family has to truly believe that their child has Autism. That they are not going to snap out of it, or simply outgrow it. Another difficulty for the family may be the unfamiliar ‘autism’ terms and concepts they will encounter. Parents may also have difficulty creating the immediate changes necessary, due to the daily routines and demands of their own lives. An alternative strategy would be to begin with establishing the family’s more structured, day-to-day routines.
< My Thoughts > “Parents may also have difficulty…”
Know what you can and can’t do. Know your child’s strengths and their willingness to accept and make these changes. You will find that there is hope and there is help, as you continue to explore ways to ‘know your child’.
For instance, ABA has been said to teach your child to adapt to the environment, while TEACCH is said to adapt the environment to suit your child. The programs seem to be ‘polar opposites’; therefore, they probably will have conflicting results.
The severity of a child’s behavior, the amount of support, the temperament of the child and parents all contribute to the family becoming isolated or seeking help. Help can come from Programs, Therapies, & other Interventions. Thompson tells us too that intensive home-based therapies require strong family skills and collaboration. That parents are the conduit by which therapists’ efforts are realized.
Even if your child hasn’t been diagnosed yet, s/he may be eligible for Early Intervention Services. The IDEA Law says that children under the age of 3 years old who are at-risk for having developmental delays may be eligible for services.
REFERENCES: UNIT 7-2 WHO MAY HELP? OTHER THERAPIES, CAMS; SECTION 2;
4. (TEACCH)Treatment and Education of Autistic & Related Communication-Handicapped Children
Edelson, S. (2019). Structured Teaching – TheTEACCH Method; Retrieved online from – www.midwayisd.org/cms/lib/
Mitchell, S. (2012). Autism Goes to School: School Daze Series, Book 1; eBook Edition.
Stokes, S. (2019). Structured Teaching Strategies for Supporting Students with Autism?; Retrieved online from – https://www.naset.ort/index.php?id=2758/
Thompson, T. (2012). Making Sense of Autism; Second Edition. Baltimore, Maryland: Brookes Publishing Company.
Wood, J., Fujii, C., et al. (2014). Impact of Cognitive Behavioral Therapy on Observed Autism Symptom Severity During School Recess: A Preliminary Randomized, Controlled Trial; Journal of Autism & Developmental Disorders; V44, p2264-2276.
DISCLAIMER (2024) Know Autism – Know Your Child: with < My Thoughts > by Sara Luker; 2024
Just to let you know that I, Sara Hayden Luker, have put forth my best efforts in presenting what I have learned about autism, by sharing the stories and studies of those who have gone before us. Any author’s mention of products, services, treatments, and interventions or actions are not to be considered an endorsement, thereof. Know that to some, autism is an ‘unregulated business’. The content of this website material, digital or in any other form does not represent medical advice; nor does it constitute medical suggestions in any way. The material, including any downloadable parts, is for informational and/or educational purposes only. Your download and/or use of any of this material indicates your acceptance of this disclaimer.
This is a Personal Use Electronic Download. By downloading, you hereby agree and acknowledge that you are not acquiring any right, title or interest in, or to, the material; nor any associated copyrights, other than the right to possess, hold and use for personal, non-commercial purposes. Furthermore, you agree that you will: (i) not scan, copy, duplicate, distribute or otherwise reproduce the material(s) to resell, (ii) not use the material(s) for any commercial purposes. By purchasing/downloading you agree to these terms unconditionally. No ‘rights’ are given or transferred.