Tuesday, October 23, 2018

#5 in a series: 8 things you need to know about working with children with autism

Thanks for hanging with me - back to school madness and a spine surgery has kept me away, but I'm back and ready to talk about the 5th thing YOU need to know when working with children who have autism. 

All the research on autism points to the fact that these students have extreme difficulty with generalization. Therefore, therapy should occur where the child “lives” the most.  For us, that is the classroom. 

Does being in the classroom come with challenges? Yep, you bet it does! It's probably loud, distracting, possibly even chaotic and not the ideal scenario you had in mind. The thing is... it's probably more bothersome and distracting to YOU than it is to your student. Also, if it's really out of control, find a more isolated area like the "changing corner" or tuck away behind the easel or the "kitchen center." I bet you're thinking, "Mia, are you telling me you never ever pulled kids to your room?"  Nope, I did it. I loved it. It was just us on the cozy rug or at my tiny table. I'll tell you why you shouldn't repeat my mistakes. 

To create generalization, we HAVE to work on establishing cognitive flexibility. 
Cognitive flexibility is the ability to adapt our knowledge to new and unexpected conditions.
It us our job, and the job of special education teachers, to facilitate cognitive flexibility.

What good is obtaining a skill, if the child can't use it in a variety of environments & scenarios and under different conditions? We can really only say a child has learned a skill when he or she can apply the skill across persons, places and circumstances.

I can tell you that when I pulled kids to my therapy room, I got kids to do things that shocked and awed their teachers and parents, but the problem was, they would only do it for me and only in my therapy room. Don't repeat my mistakes. If a child can't use communication our in the world, it doesn't matter what happens in your therapy room. 

Think about those IEP goals we write....we often stipulate what context a child will perform targets skills (with which people, place, and circumstance). AND YES, children need to learn target skills under prescribed conditions, but the ULTIMATE goal is far beyond that.

Let me tell you how....

1) NEVER teach a skill the same way with the same activity 2 times in a row!
Vary activities and materials all the time. Change SOMETHING each session so that the child doesn’t get “locked in.” These kiddos aren't like our babies who need constant repetition to learn play schemas. For children with ASD, if do the same activity or use the same items, you are creating rote learning and the child may become upset if it is broken. Plus, that the student will only be able to apply new learning if all the stars align! Did I make the mistake of repetition, repetition, repetition? Oh yes I did!! If I used interactive books and props for 3 sessions in a row (and the student liked it), you can bet there was a meltdown on day 3 when I tried to spring something new on him. Sometimes even on day TWO there was a meltdown. We have to keep them from "getting stuck" by changing things up all the time.

2) Share activities and strategies that work with every service provider. Us SLPs have lots of great ideas, tricks activities, and let's face it.... COOL STUFF! As much as we want to hold them close, we really have the responsibility to share them with the child's teacher, OT, PT, etc. if they motivate our student(s) and facilitate communication. Be confident and generous enough to share your knowledge and your goodies because it's important that our kids with ASD experience a variety of activities with lots of different people. Don't box yourself in as the "Cariboo lady" or the "Playdoh therapist" so that the child associates only YOU with your fun stuff.

2) Use the child's preferred activities (you know, those things he obsesses over) but that has to start and end fast because with that item around, they are talking AT you, not WITH and they will likely only be able to talk about that object. We all know the students who will do anything (even school work) if it involves INSERT OBSESSION HERE (Scooby-Doo, whales, iPad, fire trucks, dinosaurs, instruments, beads, etc.) The fact of the matter is that they will have to eventually go out into the world and communicate, behave, wait, request, eat, play, and just exist without their special item. So should you USE the obsession to establish rapport and possibly even joint attention? Yep, you should. Then you should quickly introduce different irresistible items to your interactions, and within a few sessions, start excluding the preferred item (aka obsession).

4) Watch your own words. Just like activities, you need to vary your language every session. We all know that these little ones are prone to using echolalia. They will pick up your language, and while that is sometimes cute, it's rarely functional. I once had a grad student who continually used the phrase, "Good job, Cooper" to praise a student during therapy. I sat and watched and as soon as the session was over I planned to talk to her about it. As she stood up to walk the little boy back to class, he said, "Good Job Cooper." She immediately frowned and looked at me and said, "I caused that didn't I?" Yes, she did cause it. All I could do was laugh, and also feel very proud that she had realized that on her own...well, with a little help from that precious little guy. We to facilitate our students' own language, not just help them steal our own.

I'm betting as you read this, you have the picture of a child in your mind. I bet you think about him or her often...even when you're not at work. I hope some of these tips will help you, and if you try any of them, I'd love to hear how they worked.

Thanks for hanging out with me today! You've got this!

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