Learning a Route Game

Young children with autism often appear to be living in the perpetual now with a mental focus that is only the width of one sensory experience at a time.  If the child is seeing then seeing is all.  If the child is touching then nothing but touch exists.  The child sees a stick on the ground and picks it up looking intently at the length of it.  But if the child then notices a bright patch of grass in the sunshine and moves toward that, he drops the stick as though it has ceased to exist.  Placing the child in a sandbox may inspire the child to run sand through his fingers over and over, consumed by the feel of the sand and oblivious to the child sitting a few inches away digging with a plastic shovel. It is as though each sensory experience is so all consuming as to cause everything else to fade into nothingness.  This is, I have heard and I believe, because the child has a sensory system that takes in information at ten-fold the typical intensity.  Being so caught up in each sensory experience is one of the neurological hazard of having a sensory system that is so acutely sensitive. None-the-less, it is the aim of every kind of intervention to help the child with autism learn to detach mentally from the clutches of such sensory experiences enough to begin to connect a set of sensory experiences into a larger framework. Eventually, we want the child to know that "Going to play at the park" includes the experience of picking up sticks, running on the grass in the sunshine, playing in the sandbox and we want the child to know that the park includes activities that can be chosen like swinging, sliding, climbing or drinking from the drinking fountain. We want the child to learn to shift attention between what he is doing in the sand box to watch what other children are doing and eventually to imitate and then join in when a different activity looks like fun.

Route Games, for a child at this stage of development are little routines, typically a sequence of sensory treats that occur in order, one after the other so that the child can learn how to detach from one sensory experience intentionally and move on to another sensory experience.  Below, you can see a little boy learning over the course of two therapy sessions, a three location Route Game.  He has learned how to go up and then slide down a slide.  He can jump with dad on a trampoline.  He has learned to put a ball into a basketball hoop.  Now, we want him to learn how to move intentionally from one of these activities to the next.  We use a photo of the trampoline to help him move from the slide activity to go and jump--which is an exciting thing for him to learn.  We then use the ball to help him move toward the hoop.  Here is the Route Game as he learns it:

Don't Ask The Question if the Child Can't Answer It

Learning to talk to young children is an art that takes time to learn and requires thoughtful consideration of the child's perspective. For example, from the child's perspective, it is uncomfortable to be asked a question that he or she can't answer. But asking questions is what many adults do more and more frequently when a child has a language learning difficulty. It is hard habit to change, I have noticed as I have tried to guide parents away from asking unanswered questions and I have wondered why. Why do they keep asking questions when the child does not answer? Perhaps, it is because, as a culture, we tend to ask questions of babies and pets who can't, of course, answer.

Today, in the city rose garden, a women waited with a beautiful dog while her companion went in the restroom. Where's daddy? She crooned. Where'd he go? Where's daddy? Where is he? Where's daddy? Where's daddy? Where is daddy? and so on, the question fainter and fainter as I walked toward the flower beds but continuing until, I presume "daddy" came out again. I winced a bit because I had had a similarly fruitless question asking session with my cat, Shadow this morning. What do you want, Shadow? I asked. You have water and you have food. What do you want? I really hope that I did not ask the question as many times as the dog lady but I definitely asked my cat some questions that I knew would go unanswered. In my own defense, my question was real. I could not figure out why Shadow was following me around and meowing pitifully. Whereas, I firmly believe that the dog lady knew perfectly well where the dog's "dad" was.

When my oldest daughter had her first job babysitting a newborn baby, she came home discouraged because, she said I did not know what to say to a baby. I told her, You just say anything you want. You tell the baby that he is beautiful, that he has sweet little toes. You ask the baby if you can eat his sweet little toes. You ask silly questions and then you give silly answers to your questions and none of it needs to make any sense at all. Babies are just listening to the melody of what you say and soaking up all the love that you express with your voice, your face, and your touch.

But talking to young children is not the same as talking to our beloved pets or our precious babies. Young children are actively trying to understand what we say and trying to respond. They feel embarrassed and frustrated when conversation becomes too hard. We need to load the deck in their favor as they try to learn how to participate in conversation. Young children with ASD find conversation even more difficult and we really need to load the deck in their favor. We want the child to want to communicate and this will only happen if the child is successful.

Answering questions is the hardest part of early language learning. Imagine trying to learn Arabic or Hindi and everyone around you keeps asking you questions in this difficult language. You don't know how to answer the questions. But this does not seem to matter to anyone. They don't stop asking you questions, they ask more questions instead. This would be a nightmare. But this really happens to young children with language learning difficulty. Most adults seem to go into a kind of hyper-questioning mode of conversation when the child does not answer questions--even with nonverbal children who never answer a single question.

OK. Kids don't necessarily feel that all that question asking is a nightmare. For most children the behavior is just a little confusing and children cope by ignoring language that is hard to understand. But, if you really want to have a conversation with a child, many strategies work better than the strategy of asking the child a question that he or she can't answer.


Next Post: What to do Instead of Asking Questions

Using a Funny Sound

Sometimes, something as simple as using a funny sound can make a game work. I recently watched a game that I have started calling: Do it Together. It is a classic Relationship Development Intervention Game. It was also exactly the kind of play that Dr. Greenspan describes in his Floortime literature. Whatever you call the intervention style, the key element was the sound she made.

In this game, a mother and her son were putting items into a container together at the same time. This was a simple repeated activity. It was relatively easy for her child to see that this was the structure of the game which is another trick to making games work. Still, there was no obvious reason for this little boy to get up from what he was doing, walk across the room and do this activity with his mom. But he did because his mother added something that interested him even more than the dropping activity. She made a funny sound each time she dropped an item in the bucket. She could have made her son come over and do what she did—but she tried instead to get her son to come to her willingly and join her because he wanted to do so. This was an important element because every time he comes to her of his own freewill and it goes well, he is more apt to independently join her again--which is an important goal in itself.

I think of the funny sound strategy as The Hook. The interesting sound enticed him to come over and imitate her. She was watching him carefully and noticing what interested him. As soon as she started using a single sound rather than various sounds, her little guy started referencing her face. He looked at her whenever he expected her to make that sound again. Now the game was socially predictable. Her son was hooked into the play and hooked into her role in the play. She was able then to work on the game objective, which was to help him learn to coordinate movement with her. She varied the timing and helped him learn to watch for and vary his own timing to match hers. Absolutely cool game!