KNOW AUTISM, KNOW YOUR CHILD with < My Thoughts > by Sara Luker
UNIT 3 What Is Most Concerning?
INTRODUCTION
CHAPTER 2 – Speech & Language Communication (Including 'Nonverbal' &
assisted/alternative, Tantrums & Meltdowns)
REFERENCES
PLEASE READ DISCLAIMER –
KNOW AUTISM, KNOW YOUR CHILD with < My Thoughts > by Sara Luker
UNIT 3 WHAT IS MOST CONCERNING?
CHAPTER 2 – SPEECH & LANGUAGE COMMUNICATION (Including non-verbal & assisted alternative speech)
UNIT 3 What Is Most Concerning?
INTRODUCTION
CHAPTER 2 – Speech & Language Communication (Including 'Nonverbal' &
assisted/alternative, Tantrums & Meltdowns)
REFERENCES
PLEASE READ DISCLAIMER –
KNOW AUTISM, KNOW YOUR CHILD with < My Thoughts > by Sara Luker
UNIT 3 WHAT IS MOST CONCERNING?
CHAPTER 2 – SPEECH & LANGUAGE COMMUNICATION (Including non-verbal & assisted alternative speech)
INTRODUCTION –
Bradshaw, J. & Klainman, C. (2018) are persuaded that Autism Spectrum Disorder (ASD) is characterized by impairments in motor activity, social interaction, and deficits in communication. They believe the ‘communication predictor’ is determined by how well a child is able to appropriately use both ‘expressive’ and ‘receptive’ language, early in life.
As addressed in the study, ‘expressive’ speaking is using language appropriately. It is having the ability to express wants, needs, ideas, and thoughts in a meaningful way; while using words to engage in ‘back-and-forth’ conversation.
‘Receptive’ listening is understanding spoken language. It is having the ability to gain meaningful information from words which are communicated in commands, questions, and phrases which are directed specifically to them. Again, understanding what is being said, in order to engage in ‘back-and-forth’ conversation.
Other ASD predictors they mention are connected to ‘independent walking’ by the age of 1 year old. Early ‘independent walking’ opportunities affords the child with new experiences and new visual perspectives. ‘Walking’ is also important to predicting a child’s normal development and how efficiently he or she takes on locomotion between objects of interest, and/or in a way to reach out to caregivers. It is an important predictor of normal development because ‘purposeful locomotion’ increasingly motivates the child to actively explore his or her world.
Kover, S., Edmunds, S., et al. (2016) can talk about a study which examines the child’s early ‘speech’; saying their first words and first phrases are predictive of the developmental trajectories of functional behavior.
In early childhood, it is expected that a child should produce at least 10 words, by the age of 18 months. And, that the child’s ‘first words’ should consist of ‘useful speech and language’. It is important that by the age of 5 years old, the child is appropriately using useful ‘expressive’ language, and that they are able to understand purposeful ‘receptive’ language.
What is communication? Stokes, S. (2018) says – ‘Communication’ is a range of purposeful behavior which is used with intent within the structure of social exchanges, to transmit information, observations, or internal states; or to bring about changes in the immediate environment. Nonverbal behaviors are included, as long as some intent, evidenced by anticipation of outcome can be inferred.
Speech/verbalization becomes communication when there is a desire or intent, to convey a message to someone else. A child’s ‘expressive’ language level does not necessarily speak to his or her cognitive level.
In some disorders (e.g., autism) cognitive ability may be higher than one’s observable language skills, especially ‘expressive’ language skills. When developing learning activities, teachers and parents must figure out which types of activities are appropriate for both the child’s mental and chronological ages. Plus, a big success factor can be found when addressing the individual’s area of interest.
Because social relations are a primary area of difficulty for children with autism, it is not surprising that effective social communication is significantly impaired for these children. Both the areas of communication and social skills are tightly interwoven and interdependent.
Therefore, the development of communication skills cannot be the sole responsibility of the speech/language pathologist. While s/he may provide the ‘guide posts’ and strategies, communication must be continually addressed by everyone coming in contact with the child.
< My Thoughts > “…communication must be continually addressed …”
When the newborn baby cries out its probably to satisfy a ‘sensory’ need – I’m hungry, I’m hot/cold, I’m wet, I’m uncomfortable! These desperate cries are primal sounds made in hopes of getting a comforting response from whomever is within earshot.
When answering these cries, whether from a newborn or a toddler, try to keep to an approach which will help your child feel cherished and worthy of all the fuss. If a child’s needs are not easily met, in the only way in which s/he is capable of communicating, then it’s possible that the ‘primal screaming’ infant will reemerge.
Remember, s/he is not trying to ‘give’ you a bad time – s/he is ‘having’ a bad time!
Know too, that throughout childhood, kiddos hear and understand ‘receptive’ language much, much more than we think that they do. From the very beginning, they also ‘pick up’ on your attitude and feelings. Studies show that sensitive children see how people really feel through the ‘auras’ which surround that person.
Your neurotypical child may say, “The teacher doesn’t like me.” What the autistic child can’t always express is that they feel unwanted because when their teacher approaches, her aura turns brown. Brown is a ‘yucky’ color, like dirt and other unpleasant things.
Whippery, A. (2019) wants us to know that autistic children and adults when under stress may see ‘auras’ around people or sounds. This is known by scientists as ‘synesthesia’, which is caused by hyper-excitability of the visual cortex. But even loud or unusual sounds can trigger this kind of event. The person dealing with a child experiencing a synesthesia event, may find that the child suddenly becomes uncooperative or overly excited.
SPEECH (Including – ‘non-verbal, alternative/assisted)
Mukhopadhyay, T. (2011) – I could see the green curtains move with the breeze. I could see the leaves of the Sal-trees move, and I could see the ceiling fan move.
Even my hands moved when I flapped them. Only my lips would not move.
My thoughtful mind would wonder about the sound of my talking voice, which I could only hear when I laughed or screamed.
I promised the mirror that I would remember not to distract it with all my talking, especially when it showed me stories of the wind, and the ceiling fan, or the color of air. I promised the mirror with complete sincerity. The mirror reflected back my promise with total earnestness.
< My Thoughts > “…stories of the wind…”
Some years later, Tito’s mother helped him put his ‘stories’ on paper for all to read. Through his need to communicate his stories, her development of Facilitated Communication became available to the world.
Note: For further information on ‘Facilitated Communication’ go to MENU for – Know Autism, Know Your Child with < My Thoughts > by Sara Luker. Find on MENU, under – Who May Help? OTHER THERAPIES, UNIT 7– 7 CAMs Section 7, 8. facilitated communication (aka ‘Rapid Prompting Method’).
Driver, J. (2011) determines that developing communication skills will be difficult for those affected with autism. But there are many strategies you can employ, because we are born to communicate. Improve communication with a child and you will reduce frustration, tantrums and emotional outbursts.
< My Thoughts > “…Improve communication with a child.”
Some parents know what their child wants because s/he drags them there, or, they scream until you figure it out. It’s sort of like the old game of ‘Charades’. Okay, you’re getting warmer, almost there! Nope! Wrong way, getting cold! You may see a look of confusion when you ask your child what s/he wants because they think you know what they want, but you just don’t want them to have it.
Sonny is ‘non-verbal’, or as some say ‘non-vocal’. He doesn’t say any words so he’s non-verbal, but he really isn’t ‘non-vocal’ because when you say, “Show me what you want,” he may vocalize a noise. That noise can be a grunt to mean “Okay, I’ll show you, but with my eyes or touch.” And then when you say, “Sonny, is this what you want?”, he may smile (That’s it!). Or, he may ‘grunt’ (Nope! Try again!”); as he is continuing to try to guide you towards what he wants.
Sometimes Sonny’s response or sign is so subtle that you can miss it all together. Or, just when you think that you’ve got it and have all the clues, he presents you with a whole set of new responses! Then, he may revert back to signs or responses we haven’t seen in years; maybe just to see if we’re really paying attention. And, so it goes.
Stokes, S. (2018) says that what a young child is able to express to you is so limited, because for them to get the thoughts in their mind to come out of their mouth is an extremely complex, highly developed cognitive function. So, give your child a way to get your attention and send you into action, other than with a tantrum. And, don’t forget to teach family members and caregivers how to interpret the ways that your child is using to communicate their wants and needs, especially if it’s through sign language or communication devices.
< My Thoughts > “…communicate their wants and needs…”
Having a non-verbal autistic child, as Sonny is, puts an extra strain on our communication. Early on, we learned to ask him, “Show me what you want.” Of course, this exacerbated his tendency to drag us to what he wanted, or to where he wanted us to go. Eventually, before we all became too frustrated, we taught him and he began using ‘baby signing’. Then, he learned to use his low technology ‘Cheap Talk’ communication device to summon us. We also have a similar small push-button device which we take with us in the car.
Bradshaw, J. & Klainman, C. (2018) are persuaded that Autism Spectrum Disorder (ASD) is characterized by impairments in motor activity, social interaction, and deficits in communication. They believe the ‘communication predictor’ is determined by how well a child is able to appropriately use both ‘expressive’ and ‘receptive’ language, early in life.
As addressed in the study, ‘expressive’ speaking is using language appropriately. It is having the ability to express wants, needs, ideas, and thoughts in a meaningful way; while using words to engage in ‘back-and-forth’ conversation.
‘Receptive’ listening is understanding spoken language. It is having the ability to gain meaningful information from words which are communicated in commands, questions, and phrases which are directed specifically to them. Again, understanding what is being said, in order to engage in ‘back-and-forth’ conversation.
Other ASD predictors they mention are connected to ‘independent walking’ by the age of 1 year old. Early ‘independent walking’ opportunities affords the child with new experiences and new visual perspectives. ‘Walking’ is also important to predicting a child’s normal development and how efficiently he or she takes on locomotion between objects of interest, and/or in a way to reach out to caregivers. It is an important predictor of normal development because ‘purposeful locomotion’ increasingly motivates the child to actively explore his or her world.
Kover, S., Edmunds, S., et al. (2016) can talk about a study which examines the child’s early ‘speech’; saying their first words and first phrases are predictive of the developmental trajectories of functional behavior.
In early childhood, it is expected that a child should produce at least 10 words, by the age of 18 months. And, that the child’s ‘first words’ should consist of ‘useful speech and language’. It is important that by the age of 5 years old, the child is appropriately using useful ‘expressive’ language, and that they are able to understand purposeful ‘receptive’ language.
What is communication? Stokes, S. (2018) says – ‘Communication’ is a range of purposeful behavior which is used with intent within the structure of social exchanges, to transmit information, observations, or internal states; or to bring about changes in the immediate environment. Nonverbal behaviors are included, as long as some intent, evidenced by anticipation of outcome can be inferred.
Speech/verbalization becomes communication when there is a desire or intent, to convey a message to someone else. A child’s ‘expressive’ language level does not necessarily speak to his or her cognitive level.
In some disorders (e.g., autism) cognitive ability may be higher than one’s observable language skills, especially ‘expressive’ language skills. When developing learning activities, teachers and parents must figure out which types of activities are appropriate for both the child’s mental and chronological ages. Plus, a big success factor can be found when addressing the individual’s area of interest.
Because social relations are a primary area of difficulty for children with autism, it is not surprising that effective social communication is significantly impaired for these children. Both the areas of communication and social skills are tightly interwoven and interdependent.
Therefore, the development of communication skills cannot be the sole responsibility of the speech/language pathologist. While s/he may provide the ‘guide posts’ and strategies, communication must be continually addressed by everyone coming in contact with the child.
< My Thoughts > “…communication must be continually addressed …”
When the newborn baby cries out its probably to satisfy a ‘sensory’ need – I’m hungry, I’m hot/cold, I’m wet, I’m uncomfortable! These desperate cries are primal sounds made in hopes of getting a comforting response from whomever is within earshot.
When answering these cries, whether from a newborn or a toddler, try to keep to an approach which will help your child feel cherished and worthy of all the fuss. If a child’s needs are not easily met, in the only way in which s/he is capable of communicating, then it’s possible that the ‘primal screaming’ infant will reemerge.
Remember, s/he is not trying to ‘give’ you a bad time – s/he is ‘having’ a bad time!
Know too, that throughout childhood, kiddos hear and understand ‘receptive’ language much, much more than we think that they do. From the very beginning, they also ‘pick up’ on your attitude and feelings. Studies show that sensitive children see how people really feel through the ‘auras’ which surround that person.
Your neurotypical child may say, “The teacher doesn’t like me.” What the autistic child can’t always express is that they feel unwanted because when their teacher approaches, her aura turns brown. Brown is a ‘yucky’ color, like dirt and other unpleasant things.
Whippery, A. (2019) wants us to know that autistic children and adults when under stress may see ‘auras’ around people or sounds. This is known by scientists as ‘synesthesia’, which is caused by hyper-excitability of the visual cortex. But even loud or unusual sounds can trigger this kind of event. The person dealing with a child experiencing a synesthesia event, may find that the child suddenly becomes uncooperative or overly excited.
SPEECH (Including – ‘non-verbal, alternative/assisted)
Mukhopadhyay, T. (2011) – I could see the green curtains move with the breeze. I could see the leaves of the Sal-trees move, and I could see the ceiling fan move.
Even my hands moved when I flapped them. Only my lips would not move.
My thoughtful mind would wonder about the sound of my talking voice, which I could only hear when I laughed or screamed.
I promised the mirror that I would remember not to distract it with all my talking, especially when it showed me stories of the wind, and the ceiling fan, or the color of air. I promised the mirror with complete sincerity. The mirror reflected back my promise with total earnestness.
< My Thoughts > “…stories of the wind…”
Some years later, Tito’s mother helped him put his ‘stories’ on paper for all to read. Through his need to communicate his stories, her development of Facilitated Communication became available to the world.
Note: For further information on ‘Facilitated Communication’ go to MENU for – Know Autism, Know Your Child with < My Thoughts > by Sara Luker. Find on MENU, under – Who May Help? OTHER THERAPIES, UNIT 7– 7 CAMs Section 7, 8. facilitated communication (aka ‘Rapid Prompting Method’).
Driver, J. (2011) determines that developing communication skills will be difficult for those affected with autism. But there are many strategies you can employ, because we are born to communicate. Improve communication with a child and you will reduce frustration, tantrums and emotional outbursts.
< My Thoughts > “…Improve communication with a child.”
Some parents know what their child wants because s/he drags them there, or, they scream until you figure it out. It’s sort of like the old game of ‘Charades’. Okay, you’re getting warmer, almost there! Nope! Wrong way, getting cold! You may see a look of confusion when you ask your child what s/he wants because they think you know what they want, but you just don’t want them to have it.
Sonny is ‘non-verbal’, or as some say ‘non-vocal’. He doesn’t say any words so he’s non-verbal, but he really isn’t ‘non-vocal’ because when you say, “Show me what you want,” he may vocalize a noise. That noise can be a grunt to mean “Okay, I’ll show you, but with my eyes or touch.” And then when you say, “Sonny, is this what you want?”, he may smile (That’s it!). Or, he may ‘grunt’ (Nope! Try again!”); as he is continuing to try to guide you towards what he wants.
Sometimes Sonny’s response or sign is so subtle that you can miss it all together. Or, just when you think that you’ve got it and have all the clues, he presents you with a whole set of new responses! Then, he may revert back to signs or responses we haven’t seen in years; maybe just to see if we’re really paying attention. And, so it goes.
Stokes, S. (2018) says that what a young child is able to express to you is so limited, because for them to get the thoughts in their mind to come out of their mouth is an extremely complex, highly developed cognitive function. So, give your child a way to get your attention and send you into action, other than with a tantrum. And, don’t forget to teach family members and caregivers how to interpret the ways that your child is using to communicate their wants and needs, especially if it’s through sign language or communication devices.
< My Thoughts > “…communicate their wants and needs…”
Having a non-verbal autistic child, as Sonny is, puts an extra strain on our communication. Early on, we learned to ask him, “Show me what you want.” Of course, this exacerbated his tendency to drag us to what he wanted, or to where he wanted us to go. Eventually, before we all became too frustrated, we taught him and he began using ‘baby signing’. Then, he learned to use his low technology ‘Cheap Talk’ communication device to summon us. We also have a similar small push-button device which we take with us in the car.
|
|
,
Hoecker, J. (2018) has information that limited research suggests that ‘baby sign language’ might give a child a way to ease communication frustrations between 8 months and 2 years. During those years, children begin to know what they want but don’t always have the verbal skills to express themselves. There are many ideas when you are searching on your own for sources about teaching ‘baby sign language’.
< My Thoughts > “…ease communication…”
While you are waiting for diagnosis or doctors and professionals to help you, you can start with what is called ‘baby signing’. Depending on the level of your child’s ability to communicate, there are also adaptable ‘low tech’ devices.
Baby signing usually works because many children with autism are very visual, and will respond to early or ‘baby’ signing. Signs for – eat, drink, stop, wait, bed, toilet, stand-up, sit-down, help, finished, etc. Just so you know, very small neurotypical infants can learn how to sign.
Most babies learn to wave ‘bye-bye’, throw a kiss, and nod their head for ‘yes’ or ‘no’. Sonny will blink his eyes for ‘yes’ and ‘no’, but never nods. Don’t know why, but children with autism often make-up their own gestures. Even if they make-up signs, as Sonny does, it’s still ‘communication’ as long as you both know what it means.
Hoecker, J. has ways that you may learn ‘baby signing’, on YouTube videos, in eBooks, to give you a start. Trying them, may surprise you. But he cautions that the first sign language attempts by your child will look like loose gestures, not the real signs.
Be patient and pay attention, because they will be upset if you don’t pick up their sign interpretation right away.
< My Thoughts > “Be patient and pay attention…”
When children make up their own signs it’s up to you to figure out the sign’s meaning, before the storm builds and the tantrum comes. Sonny slaps his thighs which can mean something’s funny, or that he’s getting anxious about something; or that he’s trying to ‘sign’ something. In either case, he wants us to join in. He is participating in your world and expects you to respond to this ‘thigh slapping’ communication. Also, he may hit his head with an open hand or his knuckles. This can mean that he’s experiencing anxiety, seizure activity or that he just thought of something really funny, but it’s also a communication of sorts.
He often improvises, for instance, the sign for ‘more’ is to gesture with both hands, putting fingertips together several times. Sonny’s interpretation at first was to clap his hands together, because clapping was what he already knew how to do. And eventually, he was able to better approximate the sign for ‘more’, but he still claps his hands first, or slaps his thigh to alert us that he is signing something.
Hoecker, J. says help your child communicate wants and needs to prevent tantrums. And, that it’s up to you to teach all family members and caregivers how to interpret the signing that your child is doing to communicate wants and needs. Maybe there is some sort of ‘alert’ before the sign is coming.
< My Thoughts > “…‘alert’ before the sign is coming.”
Sonny also claps his hands loudly if he can’t remember a sign, or if I’m ‘not getting the sign, he will improvise something. If he forgets the sign for ‘hurry’ he will frantically give the sign for ‘more’ – as in ‘more faster’ I guess.
Another method of communication for Sonny are his interactive children’s books. Some of his favorites are – Sesame Street Elmo’s Play-a-Sound Pop-Up Song Book, Mickey Mouse Play-a-Song with Piano Keys, Nickelodeon Dora and Diego Interactive Sound Books. All of these are board books and take a lot of use and abuse, but have phrases he likes.
One of the reasons they’re his favorites are because he also uses them for communication, especially on certain occasions. It’s one of the Dora books which has a button that when pushed says, “Vamonos!, Let’s go!” He usually takes this when we have an appointment. He pushes it repeatedly to let everyone in the office know he is tired of waiting for the doctor or whomever.
Then there’s the Mickey Mouse book which has a button that when pushed says – “Oh Boy! Come on! Let’s GO!” He has this in the kitchen, to use when I’m not filling his cup fast enough. Then he laughs. Yes, he has quite a sense of humor, autism and all. Sonny’s MA (mental age) is between that of a 2 of 3-year-old. So, if he can do this kind of improvisation, your child should be a whiz!
Stagliano, K. & McCarthy, J. (2010) say that her daughter's photographs as a toddler show a beaming girl, happy to flirt with the camera. She made eye contact and also used imaginative play. But she cautions that her Mia never called out to her. She cried and came to get me when she needed something, but she never used her voice to attract my attention. A warning sign I missed.
< My Thoughts > “…Never used her voice…”
There is anecdotal evidence of this in parent interviews, that more often than not, a nonverbal child will seek out the nearest someone, grab them by their most easily reachable body part and attempt to drag them to whatever is wanted or needed. Reports of this covert maneuver seems to be absent in the professional literature.
With Sonny we found ourselves saying, “Show me what you want,” which resulted in him, as he begun dragging us to the refrigerator, or the toy room. So, which came first, our asking him to show us what he wanted; or, his instinctively dragging us to what he wanted? Honestly, I don’t know. This is where use of even the most elementary ‘baby’ sign language can eliminate a lot of frustration and tears, for both child and parents.
But, Driver, J. (2011) discusses that developing language and communication skills may be difficult for those affected with ASD. And, how understanding the way your child is expressing ‘wants’ and ‘needs’ will take patience and understanding on everyone’s part.
< My Thoughts > “…expressing ‘wants’ and ‘needs’..."
Most likely at some point, your child will have a speech therapist help them with the communication to express their ‘wants’ and ‘needs’. Developing communication goals frequently becomes one of the first interventions to be recommended.
WebMD Contributor (2020) considers that a speech therapist delivering an individualized treatment is crucial. An experienced speech therapist, working closely with a team of child psychologists and others can provide the communication and behavior supports the child needs. This would be the most desirable situation for everyone.
Speech therapy techniques may include –
< My Thoughts > “…techniques may include…”
These are just some of the techniques of a Speech-Language Pathologist (SLP). All children seem to learn best when they are having fun or gaining something pleasurable from the experience.
Stress and frustration can be our enemies. Often behavior improves a thousand percent when the child has effective ways of communicating, albeit with visual cue cards, augmented communication devices, signing, or typing on the computer.
Early speech therapy intervention to assist the individual’s grasp of spoken language and the need for communication should start as soon as a language delay is suspected. Usually between 10 – 18 months of age, according to this WebMD contributor.
Squaresky, M. (2014) says at age two, when son Greg’s speech regressed, we worried about his hearing. He still sang entire songs and recited the alphabet with Sesame Street’s Bert and Ernie, yet he had no conversational ability whatsoever. 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 (parroting speech). I wanted conversation. Two words, three words, a sentence, maybe?
Piven, J. (2015) puts ‘echolalia’ in the category of a repetitive and stereotypical characteristic of autism.
Whiffen, L. (2009) wants us to know, that almost two years since Clay’s diagnosis, his speech and language skills now are testing consistently within normal limits, on assessments. Vocal tone, pitch, prosody, and rhythm are adequate. Clay’s learning and memory skills were also within normal limits. He demonstrated an age-appropriate ability to shift and direct attention, and to filter extraneous stimuli to acquire information.
< My Thoughts > “…testing consistently within normal limits.”
During these two years with Clay, Leeann has had him in a variety of programs, consecutively. So, it’s really difficult for an outsider to separate out the results of just one of the programs. As many parents find, because of the need to work on behavior challenges, programs may coincide.
Another factor may be that the expensive programs for which a child may qualify, or may receive, will also be provided ‘free’ as a ‘school’ or ‘community’ service. Focusing on the progress is the main thing, and the hope that with the appropriate intervention, things may change.
As the doctor continues speaking, I begin to feel as light as a seed pod blowing through the air. Each time she says ‘average’ or ‘above average’, I want to jump up and do the victory dance.
LANGUAGE COMMUNICATION (Including nonverbal, assisted/alternative communication, Tantrums & Meltdowns)
Autism Consultant Stokes, S.(2018) believes that “the child must be able to understand the ‘purpose’ of the communication.” Does the child have or understand the “need” to communicate? What is the payoff for the child? How and what is your child communicating and how will you know? Developing some type of communication is an essential first step.
< My Thoughts > "... believes that “the child must be able to understand the ‘purpose’ of the communication.”
What is the payoff for the child? We can't always anticipate our Sonny's motives, but we can be certain that he is always trying to determine 'what is in it for him'. He is not one of those children who 'works for food'. Children with autism tend to live in their own world; communicating only their most basics needs and wants.
Having some form of early communication is extremely important because it helps with the following:
So, it’s important to be able to know what they want and what they don’t want. Later, you can move on to a more sophisticated communication program. Understand that the ‘BEHAVIOR’, tantrum or meltdown you are seeing in your child is sometimes their ONLY form of COMMUNICATION.
< My Thoughts > “…tantrum or meltdown…”
The difference between knowing when your child is throwing a tantrum and when s/he is having a sensory meltdown is important to know.
Hoecker, J. (2018) has information that limited research suggests that ‘baby sign language’ might give a child a way to ease communication frustrations between 8 months and 2 years. During those years, children begin to know what they want but don’t always have the verbal skills to express themselves. There are many ideas when you are searching on your own for sources about teaching ‘baby sign language’.
< My Thoughts > “…ease communication…”
While you are waiting for diagnosis or doctors and professionals to help you, you can start with what is called ‘baby signing’. Depending on the level of your child’s ability to communicate, there are also adaptable ‘low tech’ devices.
Baby signing usually works because many children with autism are very visual, and will respond to early or ‘baby’ signing. Signs for – eat, drink, stop, wait, bed, toilet, stand-up, sit-down, help, finished, etc. Just so you know, very small neurotypical infants can learn how to sign.
Most babies learn to wave ‘bye-bye’, throw a kiss, and nod their head for ‘yes’ or ‘no’. Sonny will blink his eyes for ‘yes’ and ‘no’, but never nods. Don’t know why, but children with autism often make-up their own gestures. Even if they make-up signs, as Sonny does, it’s still ‘communication’ as long as you both know what it means.
Hoecker, J. has ways that you may learn ‘baby signing’, on YouTube videos, in eBooks, to give you a start. Trying them, may surprise you. But he cautions that the first sign language attempts by your child will look like loose gestures, not the real signs.
Be patient and pay attention, because they will be upset if you don’t pick up their sign interpretation right away.
< My Thoughts > “Be patient and pay attention…”
When children make up their own signs it’s up to you to figure out the sign’s meaning, before the storm builds and the tantrum comes. Sonny slaps his thighs which can mean something’s funny, or that he’s getting anxious about something; or that he’s trying to ‘sign’ something. In either case, he wants us to join in. He is participating in your world and expects you to respond to this ‘thigh slapping’ communication. Also, he may hit his head with an open hand or his knuckles. This can mean that he’s experiencing anxiety, seizure activity or that he just thought of something really funny, but it’s also a communication of sorts.
He often improvises, for instance, the sign for ‘more’ is to gesture with both hands, putting fingertips together several times. Sonny’s interpretation at first was to clap his hands together, because clapping was what he already knew how to do. And eventually, he was able to better approximate the sign for ‘more’, but he still claps his hands first, or slaps his thigh to alert us that he is signing something.
Hoecker, J. says help your child communicate wants and needs to prevent tantrums. And, that it’s up to you to teach all family members and caregivers how to interpret the signing that your child is doing to communicate wants and needs. Maybe there is some sort of ‘alert’ before the sign is coming.
< My Thoughts > “…‘alert’ before the sign is coming.”
Sonny also claps his hands loudly if he can’t remember a sign, or if I’m ‘not getting the sign, he will improvise something. If he forgets the sign for ‘hurry’ he will frantically give the sign for ‘more’ – as in ‘more faster’ I guess.
Another method of communication for Sonny are his interactive children’s books. Some of his favorites are – Sesame Street Elmo’s Play-a-Sound Pop-Up Song Book, Mickey Mouse Play-a-Song with Piano Keys, Nickelodeon Dora and Diego Interactive Sound Books. All of these are board books and take a lot of use and abuse, but have phrases he likes.
One of the reasons they’re his favorites are because he also uses them for communication, especially on certain occasions. It’s one of the Dora books which has a button that when pushed says, “Vamonos!, Let’s go!” He usually takes this when we have an appointment. He pushes it repeatedly to let everyone in the office know he is tired of waiting for the doctor or whomever.
Then there’s the Mickey Mouse book which has a button that when pushed says – “Oh Boy! Come on! Let’s GO!” He has this in the kitchen, to use when I’m not filling his cup fast enough. Then he laughs. Yes, he has quite a sense of humor, autism and all. Sonny’s MA (mental age) is between that of a 2 of 3-year-old. So, if he can do this kind of improvisation, your child should be a whiz!
Stagliano, K. & McCarthy, J. (2010) say that her daughter's photographs as a toddler show a beaming girl, happy to flirt with the camera. She made eye contact and also used imaginative play. But she cautions that her Mia never called out to her. She cried and came to get me when she needed something, but she never used her voice to attract my attention. A warning sign I missed.
< My Thoughts > “…Never used her voice…”
There is anecdotal evidence of this in parent interviews, that more often than not, a nonverbal child will seek out the nearest someone, grab them by their most easily reachable body part and attempt to drag them to whatever is wanted or needed. Reports of this covert maneuver seems to be absent in the professional literature.
With Sonny we found ourselves saying, “Show me what you want,” which resulted in him, as he begun dragging us to the refrigerator, or the toy room. So, which came first, our asking him to show us what he wanted; or, his instinctively dragging us to what he wanted? Honestly, I don’t know. This is where use of even the most elementary ‘baby’ sign language can eliminate a lot of frustration and tears, for both child and parents.
But, Driver, J. (2011) discusses that developing language and communication skills may be difficult for those affected with ASD. And, how understanding the way your child is expressing ‘wants’ and ‘needs’ will take patience and understanding on everyone’s part.
< My Thoughts > “…expressing ‘wants’ and ‘needs’..."
Most likely at some point, your child will have a speech therapist help them with the communication to express their ‘wants’ and ‘needs’. Developing communication goals frequently becomes one of the first interventions to be recommended.
WebMD Contributor (2020) considers that a speech therapist delivering an individualized treatment is crucial. An experienced speech therapist, working closely with a team of child psychologists and others can provide the communication and behavior supports the child needs. This would be the most desirable situation for everyone.
Speech therapy techniques may include –
- Using electronic ‘talkers’
- Signing or typing devices
- Pointing to picture boards
- Implementing picture exchange communication systems (PECS)
- Gaining tolerance for sounds with which person has sensory issues
- Improving articulation by massage or therapy techniques
- Singing songs with individuals to improve speech and reduce stress
< My Thoughts > “…techniques may include…”
These are just some of the techniques of a Speech-Language Pathologist (SLP). All children seem to learn best when they are having fun or gaining something pleasurable from the experience.
Stress and frustration can be our enemies. Often behavior improves a thousand percent when the child has effective ways of communicating, albeit with visual cue cards, augmented communication devices, signing, or typing on the computer.
Early speech therapy intervention to assist the individual’s grasp of spoken language and the need for communication should start as soon as a language delay is suspected. Usually between 10 – 18 months of age, according to this WebMD contributor.
Squaresky, M. (2014) says at age two, when son Greg’s speech regressed, we worried about his hearing. He still sang entire songs and recited the alphabet with Sesame Street’s Bert and Ernie, yet he had no conversational ability whatsoever. 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 (parroting speech). I wanted conversation. Two words, three words, a sentence, maybe?
Piven, J. (2015) puts ‘echolalia’ in the category of a repetitive and stereotypical characteristic of autism.
Whiffen, L. (2009) wants us to know, that almost two years since Clay’s diagnosis, his speech and language skills now are testing consistently within normal limits, on assessments. Vocal tone, pitch, prosody, and rhythm are adequate. Clay’s learning and memory skills were also within normal limits. He demonstrated an age-appropriate ability to shift and direct attention, and to filter extraneous stimuli to acquire information.
< My Thoughts > “…testing consistently within normal limits.”
During these two years with Clay, Leeann has had him in a variety of programs, consecutively. So, it’s really difficult for an outsider to separate out the results of just one of the programs. As many parents find, because of the need to work on behavior challenges, programs may coincide.
Another factor may be that the expensive programs for which a child may qualify, or may receive, will also be provided ‘free’ as a ‘school’ or ‘community’ service. Focusing on the progress is the main thing, and the hope that with the appropriate intervention, things may change.
As the doctor continues speaking, I begin to feel as light as a seed pod blowing through the air. Each time she says ‘average’ or ‘above average’, I want to jump up and do the victory dance.
LANGUAGE COMMUNICATION (Including nonverbal, assisted/alternative communication, Tantrums & Meltdowns)
Autism Consultant Stokes, S.(2018) believes that “the child must be able to understand the ‘purpose’ of the communication.” Does the child have or understand the “need” to communicate? What is the payoff for the child? How and what is your child communicating and how will you know? Developing some type of communication is an essential first step.
< My Thoughts > "... believes that “the child must be able to understand the ‘purpose’ of the communication.”
What is the payoff for the child? We can't always anticipate our Sonny's motives, but we can be certain that he is always trying to determine 'what is in it for him'. He is not one of those children who 'works for food'. Children with autism tend to live in their own world; communicating only their most basics needs and wants.
Having some form of early communication is extremely important because it helps with the following:
- Reduces frustration
- Lessens emotional outbursts
- Increases parent/child bonding
- Establishes self-esteem
- Starts to promote feelings of satisfaction and control
So, it’s important to be able to know what they want and what they don’t want. Later, you can move on to a more sophisticated communication program. Understand that the ‘BEHAVIOR’, tantrum or meltdown you are seeing in your child is sometimes their ONLY form of COMMUNICATION.
< My Thoughts > “…tantrum or meltdown…”
The difference between knowing when your child is throwing a tantrum and when s/he is having a sensory meltdown is important to know.
Tantrums
Mayo Clinic Staff Writer (2018) explains that temper tantrums frequently occur because young children are not equipped to express frustration in other ways. Even their limited vocabularies can make them feel frustrated to the point of tantrumming. That’s an anatomy of tantrums.
Perhaps the child wants a toy but doesn't have the power to convince the parent... (as the child who is being denied something he wants).
Or, perhaps s/he wants to stay somewhere, but the parent says that it's time to go. These events can turn into tantrums, especially when children are put in situations that can spark strong emotions and there is an interested audience. The behavior typically subsides once the child gets enough attention or, has his or her wants met.
Susan Stokes, Autism Consultant (2007) believes that “the child must be able to understand the ‘purpose’ of the communication.” Typical early ‘non-verbal’ communication behavior is to drag the nearest person to what the child wants. Then they will tantrum until you figure out what they want. She explains that in order to develop an appropriate communication intervention program for the non-verbal child with autism, one must determine the child’s current communication abilities.
One way to start is to ask the key questions –
- Does the child seem to desire communication?
< My Thoughts > “…drag the nearest person to what the child wants…”
For most, this may be interpreted as a desire to communicate wants and needs.
- Does the child exhibit intentional communication?
< My Thoughts > “…they will tantrum until you figure it out…”
Tantrumming may be the most primitive and even the most successful type of intentional communication. A newborn’s first way to get what they want is to ‘cry’ when they are hungry, wet, or have gas. Babies cry because they were not as comfortable as they were ‘in utero’ for 9 months. Our non-verbal Sonny grunts, makes sounds, and tantrums by throwing himself down, banging his head and kicking his feet, because he has never been able to ‘cry’ nor laugh.
- In what way does the child communicate?
< My Thoughts > “…determine the child’s current communication…”
Having a child with autism brings out the ‘detective’ in parents. Determining which ‘behavior’ is a current form of communication, at the child’s present ability level becomes necessary.
- Does the child have or understand the “need” to communicate?
< My Thoughts > “…appropriate communication….”
Expressing ‘wants & needs’ are necessary at all age-levels. The communication ‘support level’ necessary to the child’s autism symptoms comes next. Matching these levels will be the key to successful intervention. For Sonny, who always seems to be thirsty; a way to let us know he needed a drink came first. His battery operated, speech generated, Augmentative Alternative Communication (AAC) device was easy for him to learn to use. He soon realized that pushing a button was easier and faster than climbing up to the cupboard to get his ‘sippy’ cup.
Next, we programmed in ‘eat’, but the word ‘cookie’ work better for him because all he ever wanted to eat were graham cookies. He went along with the diversion of eat a bite of food, then have a bite of cookie. Then, came ‘bathroom’, and ‘TV’, when he wanted his DVD’s changed.
Eventually, Sonny learned ‘baby’ signing. For many non-verbal children some sort of signing comes first. Parents can learn about both methods by going online for sources. And, of course if available, a speech / language therapist has the help you may need.
- What is the payoff for the child?
< My Thoughts > “…understand the ‘purpose’…”
Once the child understands the purpose of the communication is to get what s/he ‘wants & needs’, then they understand the ‘payoff’ for them. The simplicity of the new way to communicate may be lost on them at first, but eventually they will ‘get’ it.
Part of ‘getting it’ involves several ‘cognition’ abilities. First, many children think that parents and caregivers automatically know what they are thinking but that they just won’t give them what they want. Once they realize that is not happening, then s/he moves to the next ‘try’ for communicating ‘wants & needs’. Second, they are learning / understanding cause & effect. I push a button, or sign (action/cause) and I get what I want (result / effect).
Siri, K. (2010) knows that “tantrums may scare you in their intensity, but they are typically a cry for help or understanding or even pain. It is a communication issue and your child is as afraid as you are. During the tantrum, offer support and comforting soothing words and actions.”
< My Thoughts > “…support and comforting soothing words and actions.”
With Sonny, we ‘sign’ and ‘say’, “Stop”, “stand-up”, “show me what you want”. At first, this resulted in him dragging us to the wanted item. So, we ‘said’ and ‘signed’ for the item, too. Then showed him how to do the same.
Finally, we took him to his AAC device to use as another way to get what he wanted. And, finally he communicated one of the more appropriate ways, instead of dragging us. This does not happen all at once, but eventually it will work. Be patient, flexible, and accept all early attempts to communicate. Change is hard, difficult, and sometimes impossible for most humans.
Gardner, N. (2008) gives us great insight into her son’s tantrums. “For over two years, our days consisted of surviving tantrums of epic proportions. They were epic in terms of both duration and the ferocity of the frustration and anger that was being unleashed by Dale due to his inability to communicate with us on any level. Dale had no idea who we were and we feared we would never be able to reach him.”
< My Thoughts > “…tantrums of epic proportions.”
This is when your child does not try to get your attention, other than in an extreme way – by tantrumming, screaming, or another disturbing behavior. Some children have even been known to cause themselves to throw-up.
Important, remember that tantrums, of epic proportions or not, are goal oriented. The child wants something that is ‘wanted’ or ‘being denied’. But they need an audience to be watching because they are trying to get control of others.
Hinds, M. (2014) lets us know that Ryan was the toddler from hell! Normal activities of daily life were now confrontations. We didn’t notice the absurdity of all the things we did, almost subconsciously to prevent Ryan from have another over-the-top tantrum. Nobody can miss a child with autism with their noises, arm flapping, and tantrums. We are so focused on getting rid of those behaviors that we fail to recognize the things they are doing right.
< My Thoughts > “…things they are doing right.”
Parents who do all the ‘right’ things, but may not be getting the help, and support needed from the professional community. Once, a doctor offered me medication to try and calm me about my son’s concerning behavior.
Thayer, N., Marsack, C., et al. (2024) examined a study about parenting autistic children from birth through adulthood. Some of these parents in the study felt that the ‘professionals’ they encountered were not very accommodating to their child’s autistic differences and not tolerant of their autistic traits. Parents felt they were facing prejudice and barriers in the social community, and unprofessional attitudes towards their autistic child in the ‘professional’ community.
Stevens, C. & Stevens, N. (2011) say that “Some other ‘less cute’ behaviors were there too – the rug-chewing tantrums, the incessant way he crashed his head against the slats of his cot. /David.”
< My Thoughts > “…rug-chewing tantrums…”
In the world of ‘autistic frustration’ the nearest thing to chew on may be a form of communication bringing the closest relief. Sonny will sink his teeth into nearby wooden objects; tables, table legs, cabinets, or his wooden blocks. Yes, this has resulted in broken teeth.
Haddon, M. (2003) tells us that when Christopher, a 15-year-old fictional Autistic boy in his story, decides to investigate the murder of a neighbor’s dog, he is mistakenly arrested as the perpetrator.
Christopher says, “When I got to the police station, they made me take the laces out of my shoes and empty my pockets at the front desk.”
“I was also wearing my watch and they wanted me to leave this at the desk as well but I said that I needed to keep my watch on because I needed to know exactly what time it was. And when they tried to take it off me, I screamed, so they let me keep it on.”
< My Thoughts > “...I screamed, so they let me keep it on.”
A possible cause of ‘tantrumming’ behavior is having a cherished object taken away. Another reason may be what the child perceives as an ‘injustice’ to him or her. Sonny may tantrum if we ask him to ‘interrupt’ what he is engrossed in doing, to do something that we want him to do. Sometimes it helps to promise that he can return to ‘it’ as soon as he does what we ask. But ‘future actions / events’ are usually nonexistent in his ‘autistic reality’. Sometimes he is more cooperative, depending on how his day is going so far.
Charlop-Christy, M. & Haymes, L. (1998) claim that often the child will tantrum when the object of the child’s obsession is withdrawn or they are given only limited possession. Also, that there usually is an ‘immediate reversal of undesirable behavior when the object of the child’s obsession is returned.’
REFERENCES: UNIT 3 WHAT IS MOST CONCERNING? CHAPTER 2 – SPEECH & LANGUAGE COMMUNICATION - Tantrums.
Charlop-Christy, M. & Haymes, L. (1998). Using Objects of Obsession as Token Reinforcers for Children with Autism; Journal of Autism & Developmental Disorders; Vol. 28:3, pgs. 177-188.
Gardner, N. (2008). A Friend Like Henry: The Remarkable True Story of an Autistic Boy & the Dog that Unlocked His World; eBook Edition.
Haddon, M. (2003). Curious Incident of the Dog in the Night-time; eBook Edition.
Hinds, M. (2014). I Know You’re In There: Winning Our War Against Autism; eBook Edition.
Siri, K. (2010). 1,001 Tips for the Parents of Autistic Boys: Everything You Need to Know about Diagnosis, Doctors, Schools, Taxes, Vacations, Babysitters, Treatment, Food, and More; eBook Edition.
Stevens, C. & Stevens, N. (2011). A Real Boy: How Autism Shattered our Lives & Made a Family from the Pieces; e-Book Edition.
Stokes, S. Autism Consultant (2007). Increasing Expressive Skills for Verbal Children with Autism; "Written by Susan Stokes under a contract with CESA 7 and funded by a discretionary grant from the Wisconsin Department of Public Instruction." Retrieved online from: http://www.cesa7.org/sped/autism/verbal/verbal11.html.
Thayer, N., Marsack, C., et al. (2024). Parental Perceptions of Community & Professional Attitudes Toward Autism. Retrieved online from – Journal of Autism & Developmental Disorders: https://link.springer.com/article/10.1007 /s10803-024-06554-5.
Meltdowns
Know that meltdowns are NOT usually a ‘thought-out’ behavior but a likely ‘sensory’ reaction. Often, when a child has a meltdown, s/he does not know what is wrong. Because this reaction may be ‘sensory’ or s/he is being overwhelmed by what is happening; like emotions out of control, or environmental stress which is beyond a child’s control.
< My Thoughts > “…beyond a child’s control.”
Others may think that your child is misbehaving, and may try to step in and discipline the child, not realizing that the child really cannot help it. Prepare to support your child by informing others about the current status of your child’s autism. Status in the areas of anxiety, communication, meltdowns, social interaction, restricted interests, stimming, and sensory issues.
He or she has a meltdown because they don’t know what is wrong. They may be having an overwhelmed response to what is happening. Having emotions out of control, or they may be experiencing ‘sensory overload’. Having an unusual reaction to the way things sound, smell, feel, taste or look.
Siri, K. (2010) says, “During meltdowns, work to keep everybody safe. At home you can have some strategies in place. When out in the community this can become difficult and potentially drag others into it; it is best to remove your child from the location as quickly as possible.
Denman, K., Smart, C., et al. (2016) decidedly say – Families of a child diagnosed with autism can find themselves trying to understand their child’s behavior while on the waiting list for ‘formal diagnosis.’ How this ‘parental making sense’ of behaviors affects parenting in the meantime is important. Confusions can also occur for the children who have insecure attachment patterns as well as sensory impairments.
For instance, parents may have difficulty understanding how a slight change in routine can cause a child to have a sensory ‘meltdown’, in the middle of the street. At the same time, parents may be more concerned about the need to present a ‘positive parenting identity’ to friends, family members, or others who are viewing the ‘middle of the street meltdown’.
< My Thoughts > “…viewing the ‘middle of the street meltdown’.…”
Aggression, violence, and other challenging behavior may really be signs of ‘sensory issues’. When viewing that ‘middle of the street meltdown’, or middle of the grocery aisle, an uninformed society may be determined they are seeing a ‘bad kid’ or ‘bad parenting’, or both.
Duan-Young, D. (2014) explains that the sound Aimee let out was like something you would imagine a wild animal would make. First the bed clothes were ripped off the bed. Next, the mattress came off the bed. Aimee had recently come to live in our group home and this was her way of ‘communicating’.
Aimee was not able to verbally communicate. When she became frustrated, or wanted something and didn’t know how to express herself, she would do the only thing she knew. She would become physically violent and destroy whatever was near her.
From a behavioral analyst’s point of view, every behavior has a function, or intent.
< My Thoughts > “…every behavior has a function, or intent.”
Every behavior has a function, or intent. Every behavior has a function, or intent. Every behavior has a function, or intent. It is up to you to figure out what that ‘function’ or ‘intent’ is. Most likely the behavior is a cry for ‘help’, not just ‘bratty’ behavior. But, “he or she is not giving you a bad time.” “They are having a bad time.”
Brain Balance Contributor (2014) explains that a ‘sensory meltdown’ is an incident which occurs when unwanted ‘sensory input floods the child’s brain. Once that happens, some experts think the child’s ‘fight or flight’ response takes over. This excess input ‘overflows’ in the form of yelling, crying, lashing out, or running away.
To manage a meltdown, help the child find a safe, quiet place to de-escalate. “Let’s leave the store and sit in the car for a few minutes.” Then provide a calm, reassuring presence without talking too much to your child. Maybe play his or her favorite music. The goal is to reduce the agonizing input coming at them and replacing it with something soothing to them.
< My Thoughts > "... ‘sensory meltdown’...child’s ‘fight or flight’ response takes over..."
When the child’s behavior is in response to a 'sensory issue', they may cover their eyes and/or ears. This may be confusing to the parent because at times, a child can cover his or her ears when excited and happy. If the child seems to be having a ‘bizarre response' to the environment, then most likely the bizarre behavior is a ‘sensory’ response. Some sort of overwhelming 'sensory input' which s/he cannot deal with.
Brain Balance Contributor believes that knowing the difference between tantrums and meltdowns is the key to helping a child through them. It may also help to get a better idea of the kinds of situations that can be challenging for your child. You can also explore tips on how to deal with noise and other sensitivities.
< My Thoughts > “…challenging for your child.”
Challenging for you too, because the difference between a 'sensory meltdown' and a 'temper tantrum' may not be easy to determine, the first time or two. The problem with trying to unlock a child’s ‘sensory’ needs is that what may be frightening or even terrifyingly unbearable one time may become stimulating and sensory-seeking to the child or student the next time. It may help to remember that a ‘temper tantrum' needs an 'audience' for the child to get what they want. The child having a 'sensory meltdown' has been overcome with 'sensory input' which they are neither able to filter, channel, nor understand.
Note: More about 'Sensory Behavior', go to MENU for – Know Autism, Know Your Child with < My Thoughts > by Sara Luker. Read on this website under – UNIT 4 When Is It Sensory? CHAPTER 1 Sensory Issues; CHAPTER 2 Sensory Categories, PART 3. SIRS (Sensory Interests, Repetitions, & Seeking behaviors) a. Sensory Interests, a. 1. SIBs Self Injurious Behaviors, b. Repetitious Behavior, c. Seeking Behavior.
Barnes, E. (2014) relates this – Our son, who we call the Navigator, and I stopped for lunch at a fast-food restaurant. We made it in okay, and finally to the front of the line. It was lunchtime, crowded, with lots of noisy activity. Navigator was unable to process the noisy sensory input. He looked up at me. “Do you need to go outside?” He nodded; his eyes large. We placed our order outside. While we waited, my son explored in detail the mysteries of the asphalt parking lot.
REFERENCES: UNIT 3 WHAT IS MOST CONCERNING? CHAPTER 2 – SPEECH & LANGUAGE COMMUNICATION - Meltdowns.
Barnes, E. (2014). Building in Circles: The Best of Autism Mom; eBook Edition.
Brain Balance Contributor (2014). Sensory Meltdown vs. Temper Tantrum; Brain Balance Centers. Retrieved online from – https://blog.brainbalancecenters.com/2014/11/sensory-meltdown-vs-temper-tantrum/
Denman, K., Smart, C., et al. (2016). How Families Make Sense of Their Child’s Behavior When on an Autism Assessment & Diagnosis Waiting List; Journal of Autism & Developmental Disorders; V46, p3408-3423.
Duan-Young, D. (2014). Autism: Why I Love Kids with Autism; eBook Edition.
Siri, K. (2010). 1,001 Tips for the Parents of Autistic Boys: Everything You Need to Know about Diagnosis, Doctors, Schools, Taxes, Vacations, Babysitters, Treatment, Food, and More; eBook Edition.
DISCLAIMER (2024) Know Autism – Know Your Child: with < My Thoughts > by Sara Luker
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.
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