Showing posts with label Play and Autism. Show all posts
Showing posts with label Play and Autism. Show all posts

Friday, March 5, 2010

Don't Boss a Child Around and Call That Playing

An adult might think that he or she is playing with a child when actually the adult is just bossing the child around. Just because there are toys involved, it is not playing unless there is actual play going on.  This means that people are having fun with the toys. An adult telling a child what to do with a toy is not much fun.  Most children do not respond well to this.  A second bossy and totally not fun behavior that adults tend to do with children is testing.  This is when the adult asks a question like what something is called (even though the adult knows what it is called) or asks the child other questions that no other kid would ask in similar play unless the other kid were pretending to be a bossy adult.  You don't have to ask questions to make play a language activity, and most of the time, asking questions is the worst possible way to teach a child new language skills.  Here is what this non-play interaction might sound and look like:


Do Not Do This
Bossy Adult: You try it (pointing at a toy)
Child: (ignores adult)
Bossy Adult: Your turn (picks up toy and hands the toy to child)
Child: (takes toy but does not know what to do with it )
Bossy Adult: Takes the toy out of the child's hands and operates it then hands it back to child.
Child: takes toy and looks at it but still does not know what to do with it
Testing Adult: More? (Adult wants the child to say "more" in order to get adult to operate the toy again)
Child: ignores adult
Testing Adult: Say "more"
Child: Ignores adult
Testing Adult: Is it fun?
Child: Ignores adult (but if the child could he or she might say "No, this is not fun! Not even a little bit fun!  I don't even know what to do with that dumb toy!")
Bossy Adult: Give it to me
Child: hands toy to adult
Testing Adult: Say "help me"
Child: ignores adult because the adult has not sold the child on the idea that playing with this toy is fun and the child does not actually want help.
Testing Adult: It is not wound up?  Can you wind it up?
Child: Does not respond but looks at the toy again
Bossy Adult: You wind it up.
Child: Wanders off


Video tape yourself playing with your child and I know that some of you will find, to your horror, that this is exactly how you "play" with your child.  When you are teaching a child to play or teaching a child to communicate using play, you have to play.  It is a skill you had at one time and can get back.  If you don't play with the toy, why should the child play with the toy?   How will the child know what to do with the toy? There was nobody leading this not-so-theoretical child into play.  What the adult needed to do was start to play by first showing curiosity, about the toy.  The adult needed to look at that toy like a child would and let the toy be an inspiration for exploration and playfulness.  The adult could have made this toy an inspiration for social interaction, play and language by focusing on play, playing, and then inviting the child into the play.

Do This

Adult: Look at this
Adult: Let's see what it does.
Adult: Cool!  I like it. (adult needs to actually look excited about the toy and focus attention toward the toy not toward the child) Turn, turn, turn--wind it up!
Adult: Wow!  Your turn. (offers toy to child)

Child: Takes toy from adult but does not know how to operate it
Adult:  That's tricky.  I'll help.  Give it to me.  Turn, turn, turn!
Child: turn
Adult: turn, turn, turn (grin at child because repeating words is fun)

Adult:  Here you do it, it's ready! (hands toy to child)

Child: Releases the toy so it will fly across the table
Adult: Wow!  That is so cool.  Let's do more!
Child: More
Adult: Yep!  We will do more.  I will wind it, you let it go.  Turn, turn, turn....


Monday, February 22, 2010

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:




Wednesday, January 6, 2010

Authentic Chinese Food



When I was in New York one time, the menu at the Chinese Restaurant that we visited was not the same as any I had ever seen before.  I love Chinese Food--at least the version of it that I know.  In this restaurant, however, we were the only non-Chinese looking people in the building and that seemed like a good thing until we saw the menu.  It was in Chinese. We asked the waiter to translate menu items--which he did but way too rapidly for me to comprehend. At that point, each of us moved on to choose one of the  two or three items that sounded vaguely familiar or we randomly ordered by pointing at something on the page.  I am adventurous and ordered pretty randomly.  Others in my family went for more familiar sounding stuff.  Even these items were nothing like food that they had had before.  I did not actually like my meal very much nor did anyone in my family. The new tastes were too unfamiliar to my palate and visually things looked strange to me.  I assume that if I were to live in China for a while and the dish that I tried was frequently served, I might have come to like it. What is it, something like twelve times that you need to taste something before you learn to like new things?  I remember this experience when kids back quickly away from new games and activities that I introduce. I think of this as an Authentic Chinese Food event.

The more unfamiliar elements in a game that I introduce, the faster kids reject my bid to play together.  If I manage to sandwich new elements of play into familiar games, this makes it easier for children to try new things--so I do this quite often.  I use video models (video clips that show a child the new game) to introduce some new games because this really helps us get to that point that is like tasting a new food for the tenth time and you are at least able to tolerate it. If I put things that a child loves into new games--well this can go either way--sometimes it help a child enjoy the new game and sometimes the child reacts the way I would if you put an unfamiliar Chinese ingredient into my favorite desert.  Covering new ground with a child who has autism, (which is usually the point in a therapy session), is quite a tricky proposition.

Monday, November 30, 2009

What Are YOU Looking At?

Here is another selection from a page on the new, soon to be published Autism Games Website from the Advanced Games Section: 



Cariboo Cranium is a game that  we have used in our clinic to integrates pointing into a more complex thinking game.  This game is meant for children who are able to understand a complex set of rules and it is often harder to teach than it appears on this video clip.  In this version of the game, I am looking at a card which tells me what door can be opened but the girls playing cannot see the card.  They ask if they can open a door and I nod yes or shake my head no.





The game is meant to help children understand a bit about something that is often called Theory of the Mind.  Theory of the Mind refers to the awareness that different people have different "minds".  Each person knows different things because he or she has had different experiences and has seen and heard different things in life.  A poorly developed Theory of Mind would lead a child to believe that everyone knows and feels the same thing.  It may be that children with autism do not naturally develop as sophisticated Theory of the mind and for this reason, we have tried to include some games that are designed to help children understand that no two people see, hear, or think the same things This Cariboo game has several elements that tend to interest young children with autism.  It has doors that open, balls, and a treasure box that opens at the end. The game is not longer sold by Cariboo but I find the game often at the Goodwill (and I buy them up to give away).

Sunday, May 17, 2009

Musical Games


Most of us know that play is more difficult for a child with autism and that it is important to the child's development but what is it, exactly, about play that makes it important? How important is it as opposed to, say, direct instruction in language skills, social skills, or daily living skills?

Parents will often ask a question like, With a limited amount of time, are you really sure I should spend time playing with my child? I keep searching for ways to explain why play is so important. I saw the possibility of another way to explain this as I watched a video on Erica Smith's Blog.

On this video, Erica is demonstrating a kind of social musical play for young children created by a German composer, Carl Orff. The activity is highly structured but, by my definition, it is social play because the four year old girl, Morgan, has the choice of what notes to strike, she is enjoying herself and Morgan and Erica are clearly playing music together--each aware of and responding to what the other is doing. This game has all the elements that I look for in games for children with autism.
  1. Social reciprocity--an activity where both players are important to the fun and success of the game.
  2. Structure--enough structure that the child knows what to do and does not feel confused or anxious while playing.
  3. Choices--opportunities for the child to make choices from among two or more possibilities, thus allowing the the child to develop more and more ability to observe, analyze, and choose what to do moment-by-moment.
  4. Playfulness so that the child can enjoy and learn from the process regardless of the outcome.

Most musical training seems to be about teaching a child to play a predetermined set of notes at the exact right time in order to re-create a composition created by someone else. There is great value in this kind of training--in music and in all fields of knowledge. But this kind of training is not enough--particularly for a child with autism because playing an original composition is the real goal. Whether it is when a child combines two words in a novel way to create an original sentence, responds to a question with an original answer, or co-creates an original scene for a puppet show--anyone who loves a child with autism knows that these are the most cherished moments of all. Playing with a child in a multitude of ways offers the child with autism the opportunity to learn the art of original composition.

Sunday, March 15, 2009

Getting All My Ducks in a Row

Much to my husband's amusement, I am writing still another post on rubber ducks. In a previous post on Ducks and Duck games, I suggested buying ducks in pairs but apparently failed to make it clear enough why matching pairs of ducks are better than single ducks. A reader suggested I clarify this so I am using this suggestion as an excuse to take more duck pictures and write more on playing with rubber ducks. This is my third post on ducks and if I continue on this track, I may have to make a new blog, just for rubber ducks. Regardless of the toys you use, it is my hope that thinking about the play ideas I suggest here will help you create more imaginative and engaging games for your child. I am moving the three posts on ducks so that they are all in a row and thus easier to read one after another if you are so inclined.

Setting Up A Visual Pattern
I engage children with autism in games with a number of strategies but none is so fail-proof as creating an obvious visual pattern. Repeating this visual pattern a few times and then inviting the child to help me continue is so successful that I use this play principle in dozens of games.

It is easy to set up visually obvious patterns with rubber ducks. Rubber ducks are bright colored. They all have the same unique but obvious ducky shape. If the rubber ducks vary just a little, but they come in matching pairs, matching rubber duck pairs is a still more obvious visual pattern.

Simply matching duck pairs is enough of a game to get some children involved. If you have enough duck pairs, you can just keep setting out one of a pair, hand your child the second in the pair, and your child will add the matching duck to a simple duck parade. This can happen on the edge of the tub or under the kitchen table or pair-by-pair up the steps to the second floor of your house.

Simple language is easy to add to a game of pairing up ducks and language both complicates the game in some delightful ways and teaches your child new words and new pretend play ideas. You might quack each duck up to the parade and that would be fun for a while. You might up the drama with simple pretend play ideas like knocking ducks over, kissing bruised feathers, and putting on bandages. After an exhausting set of mishaps, you might put pairs of ducks to bed for the night under a tissue blanket saying Night, Night, go to sleep. These are simple play frames and just right for some children.

Other children will enjoy much more complex language and more complex play ideas. A duck story is easy to weave with these versatile actors, since they can say or do almost anything that your child and you can imagine. If your child is ready for more complex duck tales, weave stories of high crime and drama. Remember the world from your child's perspective and you might be inspired to create stories of ducks that are naughty and won't go to bed. Ducks that are hungry but will only eat green worms. Ducks that are angry because sibling ducks get to sit next to Mommy duck in the front seat of the car. Ducks that are scared of loud noises or get lost from the pond because they wander off alone. In duck world, retell the story of your child's life. Telling such stories with ducks makes the story more concrete and the use of duck re-enactment can help a child listen, comprehend and enjoy whatever story you might tell.



Ducks Get Lost

All the ducks are in the pond. Oh No! One Flower Duck left the pond. Flower Duck is lost! Flower Duck, where are you? Everybody, look for Flower Duck! Flower Duck is in the house! Yeah! We found Flower Duck. Come down Flower Duck. Come back to the pond. Now Two Flower Ducks are together! Yeah!


Oh No! Now One Birthday Duck is lost! Birthday Duck, where are you? Look for Birthday Duck! Birthday Duck is in the house! Come out Birthday Duck. Come back to the Pond. Now two Birthday Ducks are together--that is happy.




All the ducks are in the Pond. Don't go away ducks, you might get lost!

Having matching ducks is motivating to many young children with autism--simply because it is a visual pattern that is easy to see. Matching ducks may still be motivating for older children with autism who might be ready to start enjoying longer pretend play stories but still find it hard to listen to that much language. One duck missing from a pair is visually easy to understand and is a pretend problem that will matter to most children. The rest of the story, if it resonates in a child's life or delights a child's sensibilities can gradually make sense. Putting together duck pairs works to sustain attention so that play and language skills can grow.

Saturday, March 14, 2009

The Ducks Go Marching Two by Two

If you play with toys that come in matching pairs, you will multiply the game possibilities by more than two. I recently bought two large sets of rubber ducks, so, now I am busy thinking of games to play with the duck pairs. These ideas would work with lots of toy pairs. The previous two posts are related to my recent massive duck purchase and you might like to follow-up by reading these previous posts if you have a collection of ducks or any other large critter collection.



I set out my duck sets today determined to discover new ways of playing with them. In my play room, I split a low table in half with masking tape. In my mind the tape was meant to serve as a kind of fence. My plan was that whoever I played with would get one side for his or her ducks and I would get the other for my ducks. I have so many ducks in this collection that I felt we could split them up and still each have plenty. When the first child of the day, Carter, came to play, I put a Popsicle People Doll of me on my side and a Popsicle People Doll of Carter on the other side. He had never seen the table set up like this so I had to explain it. This is Carter's side, I announced and this is Tahirih's side. (See note below for explanation of Popsicle People Dolls)

Hmmm I pondered aloud, right after Carter sat down, I want Car Duck. I put the duck that I have named Car Duck on my side. Here Carter, this is Carter's Car Duck. With two identical ducks of many kinds, the game became about each of us getting one each of every kind of duck. I showed Carter how to request ducks by doing it first. I want Guitar Duck! I said next--and after three or four ducks were handed out, I waited for Carter to request a duck.

No matter what level of skill a child has, I can show him or her a way to request. With a non-verbal child, I might teach the child to push a talking button that says Duck Please. For a child like Carter, I gave each duck pair a name like Car Ducks, Golf Ducks, Fireman Ducks showing him words to describe/label ducks and showing him how to combine words. For a child who is able to engage in pretend play, I might sell ducks from the box of ducks making the box into a duck store.

Carter is not quite ready to play like this but if he was ready, I would have handed Carter's dad the box and suggested he become the Duck Salesman. I would have taught Carter how to request a duck at a Duck Store by saying How much is your Fireman Duck, Sir? Carter's dad might reply saying Fireman Duck costs five cents! Setting up a Duck Store would be as easy as placing a sign on the box that says Ducks for Sale! With a Duck Store, we could play any number of buying and selling ideas. Today, Carter was introduced to the idea of collecting ducks on his side of the masking tape fence but in a year, he may become a duck entrepreneur. Toys don't really have to get old if you use them in new ways.


Now it turned out that Carter had his own idea about how to play with ducks. He wanted both of the Car Ducks, and both of the Golf Ducks, and both of the Pit Crew Ducks, so I quickly made a change in my plan to accomodate his interest in pairs. We both began to collect duck pairs. I mention this because it is easy to get caught up in your own plans for a game and miss using a child's much more motivating ideas. With Carter, I began to offer him pairs rather than single ducks. Carter likes letters too, so we put pairs of ducks on letters.

Depending on the child, this pair duck game might have become all about negotiating for favorite duck pairs, trading duck pairs, complaining when a duck does not have an identical matching duck pair, choosing girl ducks versus boy ducks, or as mentioned above, selling and buying duck pairs. I might have quickly put up a sign on the Duck Store that read Ten Ducks for a Quarter! and pretended the idea of buying in bulk. I hope that Carter starts to understand pretend play like this soon. I have lots of ideas for when he does.

Note: Popsicle Dolls are paper dolls with a real person's face on the doll, and the whole doll is stuck on a tongue depressor stick. I don't think that Tongue Depressor Dolls sounds as good a Popsicle People. More about using this strategy on Autism Games under Family Dolls

Friday, March 13, 2009

Rubber Duck Games


There are as many games to play with Rubber Ducks as there are variations on Rubber Ducks. Start by getting a cool collection of say, 10 or more ducks. The more the better--up to a point. Click here for one extensive duck collection or visit any toy store--but get identical pairs of ducks and make sure each pair is distinctively different from the others. Let's start with a traditional play idea:

Bath Game 1
(good if your child is not yet talking)

Put the ducks up on a high shelf or on the other side of the room from the bathtub then call the ducks, one-by-one Du-uck, Come here! and bring a duck over to put it in the tub. Gesture for the duck to come with your hand as you call it.


Take the ducks out of the tub, one-by-one saying Bye Bye Duck and put it back where it was on the other side of the room.


Bath Game 2

(good if your child is starting to say words or use pictures to communicate)

Take a photo of each kind of duck and laminate it--leaving a little edge of plastic around the photo so no water can get in. Play the game the same as the previous game except that you should call each duck by name while looking at the duck you intend to get for your child. Pirate Duck, Come here! Let your child pick ducks by looking at, touching, or handing you a photo of the duck--or by calling the duck. Since your child takes a bath pretty often, don't worry if he or she actually says the names of the duck or uses the pictures to choose--just keep playing the game every bathtime.
Bath Game 3
(Good for if your child is talking and you are working on conversation)
Play as in previous games, only after you and your child have settled on names for all the ducks, use clues to get the ducks. For example, you say: A duck that has a red hat. Your child says Fireman Duck!
More duck games to come.....

Thursday, March 12, 2009

Why You Need Flocks, Herds and Collections of all Kinds


I use flocks and herds and collections to entice young children to play with me. One reason is that collections are intrinsically interesting. There must be some kind of a collector gene in our DNA because we are all drawn to collections. Even more importantly, once you have a child’s attention with your collection, there are so many ways you can play with a group of—well, anything.

The gaggle of geese or menagerie of Beanie Baby animals or set of colored markers works better for conversation if they vary in some interesting ways. Below is a set similar to the collection I use:

I often set Beanie Baby Animals all in a row because it is easier for a child to see that there is a collection this way in the same way that you might line up a collection of photos on the wall for visual effect. But groups are interesting too. Sometimes I can’t put the whole collection out at all because for some children a group of inviting things leads to a strong hoarding instinct and the child will need to gather and hold the collection. Once your child has the collection in his or her possession, the possibility for playing together with the collection is often over as you will have to wrestle them away to do anything else and the fun factor has gone to negative ten. Sometimes I use a high shelf on the wall to set the collection on so the child can see it but not get it all at once. This is such a good strategy that I suggest all families put a high shelf on the wall in the room where they play. Sometimes I take pictures of all the items in the collections and keep the real collection hidden away until needed allowing us to discuss and assemble the collection using the photos as a point of reference.

Many games that can be played with a collection are based upon 1) getting the collection to your child item by item in some interesting way, 2) doing something interesting with each item, 3) taking each item away in some interesting way. One child that I knew (and whose mom reads this blog so it will be interesting if she remembers this) loved long skinny things so I started collecting pens. He would pick up a picture of a cool pen and then I would get it for him. We would draw something quick with each pen and then he would hold it and study it, which is what he really wanted to do. I would say Bye Bye to the pen, naming it again, then putting it away. We had a little trouble with this last part for several days as giving each one up was hard but it got to be fun because he knew what was next. I quickly offered pictures of other cool pens and he selected the next one and we did it all again. I saved his favorite pen for last as he would never have given that one up quickly enough to make the game move forward at a good pace.

With a child who had more language, we might have drawn together for much longer, talking about what we were drawing and I might have set each pen upright after we were finished in a long snake of play doh so that he or she could see the collection growing pen by pen.
We can gather a collection with hide and find games or collect them by asking family members for items in the collection or send each one under a door to the child—there are endless ways to get the collection to the child in an interesting way. The items can be called, named, scolded, used, analyzed, rated, sorted, washed, displayed, photographed, lost, found, altered, wrapped, given, or hidden. The only limitation on what you do with a collection is the scope of your imagination.
March, 2009 Posts will include a Duck Collection Set of Games.

Wednesday, January 14, 2009

Words are Gems to Collect

"As toddlers, first we grab and then we grab with words. Every word we learn is an acquisition, a bit of gold that makes us richer. We catch a new word and say it over and over, turning it like a rich nugget in the light. As children, we hoard and gloat over words. Words give ownership: we name our world and we claim it."  by Julia Cameron, The Right to Write

Children with autism often acquire words later but whenever it happens, it is just as wonderful to them and to those of us who have been waiting.  It is an extraordinary time to witness--that period when a child first understands words as gems--intrinsically interesting, available to collect, and magically powerful in both the internal world of thought and the external world of social interaction.  How surprising it must be when a child first comprehends that fleeting strings of sounds can represent objects, movements, events, time, color, feelings.  These words turn young speakers into poets, scholars, and rulers.

An example: One four year old, very new collector of words, looked out the window last week, and he studied a helicopter taking off from a pad on top of the hospital. Noisy fan on, he said after a thoughtful moment.  Because he had found, in his new shining collection of words, three words that were perfect, he suddenly was a poet, a scholar, and a king.  He was a poet because he combined words in an original creative way to express his thought.  He was a scholar because he had a tool for recording his observation and a way to share and discuss his discovery.  In the world of his own expanding imagination, he was a king who could rule over the roaring flying fans that would quickly join cars, trucks and trains in the kingdom of his play.

Bella Luna Wooden Helicopter

Tuesday, September 16, 2008

Bop & Jump

Many parents report that a mini tramp is the best thing that they ever bought for their child with ASD and a lot of families own them so that their child can jump in a designated place. Jumping, I hear from my Occupational Therapist friends, is a very calming and organizing sensory activity. I try to create games that use these little trampolines because kids have them at home. Bop & Jump is one of the most loved games at our clinic and many a child has come in the clinic front door chanting You can't get me! You can't get me! Bop! Sometimes, not one word of this chant is intelligible but the melody is reproduced well enough to communicate the child's intention to play Bop & Jump, and play it soon! In other words, this game is very popular with kids.


Watch the video clip below and then read the rest of this post.

Bop and Jump teaches many things, depending on what language is used and who plays it with your child. One thing that it teaches particularly well is that there are different roles in a game (and a conversation) and each player (or speaker) may play different roles at different times. Here are the Bop and Jump player roles:



  1. Bopper--who stands on a designated spot, in our case a big orange flower placemat, and eventually bops the jumper with the very soft ball

  2. Jumper--who jumps up and down on the trampoline until the bopper, bops him or her with a very soft ball.

  3. Waiter--who sits in a chair and waits to be a Bopper or a Jumper (this role is only needed if more players are participating)

All the roles in this game may require hands on assistance when a child is first learning to play the game. Many children get mixed about who does what at the beginning. Parents need a very soft and safe place for the child to jump onto when bopped. I often start by just picking kids up and dropping them onto the Bop landing spot after they have been bopped. It is easier than explaining it and kids like to be picked up and dropped in a soft place anyway. Part of the charm of this game is the chant, so use this chant or another one with enthusiasm.


Parental Warning: Do not play this game if you think your child could get hurt doing it. Use your judgement on this "spot" your child (meaning help him or her jump safely) if your child needs to be spotted to be safe.


Saturday, August 23, 2008

Rock Games

We are visiting my son and his wife in Seattle where we are transfixed by the natural beauty all around us. Today, Nathan and his friend Eric, took us to see Puget Sound. Although my husband I were well-entertained just hiking and gazing, they were more prone to turning every environment into structured competition. At one point, they became focused not on the wide and amazing panorama before us but narrowed in on the rocks beneath our feet. Watching Nathan and Eric play inspired me to translate this big boy game into a potential little boy or girl game--just theoretically, you understand, as I don't have any little children to try my ideas on here. Mostly, I bring you games that I have tried with children not once but dozens of times. Still, I feel confident that with a little individual variation, I could take the enjoyable components of the big boy game and translate these into a simple game that a child with autism could understand and enjoy.

So, here is how the game evolved with Nate and Eric. First it was just a competition to see who could skip the rock the most times. This then became a competition requiring the most skips in ten throws--so a score was kept. Then the rules changed to who skipped the rock the furtherest after at least two skips. This was complicated a little more by requiring that the rock that was skipped be a poor skipping rock with some discussion as to what constituted the worst rocks. The rules changed at least a dozen more times, allowing them both to skip rocks until their arms ached--and then they used their left arms.



What these boys know, and what young player need to know, about playing is that they needed to challenge themselves in some way that requires increasing physical and mental skills. The challenge need not be overly complex--just complex enough to require full attention and concentration and result in more skill. They know that as soon as boredom sets in with one set of rules, one can change the rules in order to sustain focused attention and insure that learning occurs. Nate and Eric created a relatively simple but challenging game that had clear (and ever changing) rules. The game provided immediate feedback--another requirement in a good game. They could count the skips and know, within seconds that each throw met or failed to meet the goal set. The game they created was an end in itself--like a little circle that excluded everything around them and all thought outside the thought required to compete. The game provided a sense of increasing control, almost paradoxically, in such a vast and wild environment. This illusion of control is one of the most powerful reasons to play. This kind of experience is what Mihaly Csikszentmihalyi describes as an optimal experience . Nate and Eric, lifelong friends with a lot of playing experience together, knew exactly how to create and maintain an optimal experience game.

It was not long before the little boys just down the beach began to throw rocks too but they did not know how to organize the game that they were emulating. They were learning by watching and trying but they had not yet learned to coordinate a structured game that could sustain attention in the same way the big boys did. Their less organized game, without clear rules and without real feedback regarding how well they were doing, did not entertain them very long. They could and did sustain attention to the rocks and the water but they had no ability to create a game that they could play together. What they needed (and what children with autism need) was to provide a framework and structure. If someone had organized the game with saying something like: This is a black rock only competition. You both need to pick a black rock that is the same size. Then, stand right beside each other and lets see how far you can throw it. They were too little, I think to successfully skip a rock but learning to throw would have provided plenty of challenge.

There are a number of other possibilities for creating challenge and learning. In the highly patriotic tin pail you see in the photo, they might have collected rocks of different sizes, shapes, colors and tried throwing these underhand, overhand, just to the waters edge, a little bit further, a bit further yet. They could have tried for bigger and smaller splashes. They could have tried throwing several small pebbles at a time and so on. Someone would have needed to show these boys how to coordinate their actions with rocks and throwing, and how to change the goal often enough to hold boredom at bay. A game with clear, concrete rules would have kept them playing together longer and would have helped them enjoy the social pleasure of joint activity. I want to mention, although it is not entirely related, that playing in this way with a more able player would have insured that a younger player would learn new vocabulary and new concepts.

Not knowing how to create a structured game, these boys and other small children on the beach were still quite able to enjoy playing on the beach. They just enjoyed the beach as a sensory experience or perhaps a loose kind of constructive play more than a social experience. They rearranged rocks in and out of the water but not together. They piled and moved and dropped rocks. They handled and gathered and changed the color of the rocks by dipping them in water. A little girl down the beach still further was particularly focused in her play and spent a long and happy time just looking and moving little pebbles for with some purpose that was known only to herself. This is a lovely kind of play and a visit to the beach can include either or both of these kinds of play but if you want to use a bit of your recreational time, to help your child learn the social skill of playing with another person, show your child how to set up simple rules for a game that builds physical skills, provides clear and immediate feedback, and can be made gradually more complex or changed so that it does not become boring. Provide language for what your child is doing or trying to do. Organize your child with another into a game that allows them both to play together.

Tuesday, August 5, 2008

Tic Tac Tony--My Pick as a First Game



I love Tic Tac Tony as a first box game. It is easy to teach. Each game round is over quickly, allowing your child to complete the game and even to play with more than one partner before being tired of the game. It is easy to teach your child to take turns, since there is an clear visual organization -- Mommy is red and you are blue! A sneaky adult can get a turn in so fast that even if your child tends to protest when others take a turn, there is not time for protest. There is a sensory zing in this game in flinging the discs up and into Tony's belly by pulling down on Tony's tail so winning really does feel secondary, as it should be. Anyway, you need not even mention winning if you don't feel your child is ready. It is not hard to make sure your child wins more often than you do when you do want your child to learn about competition.




Monday, July 14, 2008

Dora and the Slide Game, Blow-by-Blow


Aaron was just three years old when I met him. This was several years ago now. When Aaron's mom and I first started working together with Aaron, he rarely used words. He seemed to understand a few things that his parents said, like Go outside and Time for Night Night. He seemed to comprehend the name of some of his little movie characters, like Dora and Sponge Bob. He liked small toy characters, often holding one in each hand, especially when he left home. I started with Aaron by using toys and activities that already interested him and so Dora came under consideration right away. As I was teaching Aaron's mom how to play with Aaron, I would often break down the whole sequence of our play and tell her not just what I was doing but why I was doing it and what I was learning about Aaron as we played. I would talk through sessions as much as I do in the section that follows, explaining at length a game as simple as the one I show in the video model above.



One day, the goal was to introduce Aaron to this little pretend play idea: Dora, Swiper and Boots can climb up this little slide and then slide down. Up, up, up, Weeee! I introduced Aaron to the game with this single repeated phrase and action and did not vary what I said beyond that for a while. I chose the slide because I knew that Aaron was a little afraid of slides. This made sliding a powerful pretend play idea. Children like to pretend about slightly scary things. In the world of pretend, they are safe but can explore what is scary. I call these slightly scary play ideas, Safe Emergencies. I am always looking for ideas like this that might engage a child in pretend play because a child will often try to pretend a Safe Emergency idea even if no other pretend play idea interests the child. Pretend play skills will often emerge when these opportunities are provided--a notion that I first learned from Dr. Stanley Greenspan in his writings. For many children, the slide itself, tends to make this particular game work, perhaps because a slide has such a distinctive shape and what one does on a slide is such a distinctive activity.


This pretend play idea worked with Aaron. Aaron willingly started attending as I said, Up, up, up, Weeee! over and over while taking Dora, Boots, and Swiper up the ladder and down the slide. I was thrilled when Aaron spontaneously tried to take Dora up the ladder himself but he managed only half the action before disaster struck. The ladder fell over. I knew Aaron was ready to quit the game at that point because he could not coordinate the movement of taking Boots up the ladder and keep the precarious ladder upright. Before Aaron could bolt away, I put my hand over his and helped him take Boots up the ladder. Up, up, up, Weeee! I said, to let him know why I was holding his hand. He let me do this. The week before, Aaron protested every time I tried to help him do something hand-over-hand, so I knew that Aaron really wanted to learn how to do this. I soon let go of Aaron's hand and he tried it again himself. When he still needed help, he put his hand by mine so that I would help. He never looked at me but I knew he was making a request. I did not even model the word Help. I did not want to jinx the cooperative spirit. It was a triumph for both of us when Aaron finally could take a character up without help.



Up, up, up, Weee! I would say. Swiper's turn ...Dora wants a turn... Boots is next. Now I used a few more words as we played because I knew Aaron could listen to what I said. Since he was not struggling anymore with the motor planning task of taking each character up the steps, and, in fact, was doing this easily, I thought he might have some mental room left over for listening.

While teaching Aaron's mom about the sliding game, I spent time explaining how hard learning new motor sequences was for Aaron--something his mom had not observed because Aaron tended to move quickly away from any task that was hard for him to do. She did not see his motor planning difficulty because he looked coordinated as he did most things. I explained to Aaron's mom that for Aaron, learning a new motor skill was perhaps like when she first learned to drive. You can't see how hard it was to learn to drive once the driver has learned the skill. I told her that not talking too much while a child is learning a new motor task is helpful. The new driver analogy works here, too. You don't talk too much to a new driver. A new driver needs to focus on driving. Once driving becomes automatic, then the driver can drive and talk.



As the game progressed with Aaron, my primary role became narrator of the play, because Aaron could not do this. Pretend play is much more engaging if there is language to tie it all together, even for nonverbal children. Most three year old children narrate their own pretend play but Aaron could not do that. I still took characters up the slide as I played with Aaron, though, since I wanted to be able to add new ideas to the play and I wanted the play to be social. It was not a struggle to take turns in this game, although in many other activities, if I took a turn, Aaron would try to gather and leave with all the toys. Dora wants a turn. Now Boots wants a turn. I would say. Aaron waited and watched with interest when I took a character up. I think he wanted to see what I might do next. I was quite pleased when Aaron independently lined characters up in a straight row behind the ladder--as he had seen me do previously. This indicated a deeper understanding of what we were pretending than I had expected. Aaron spontaneously started to say the words too, uh, uh, uh, eeee. This was his version of Up, Up, Up, Wheeee. This, too, suggested that Aaron was really playing. I had not prompted him to say anything. In fact, I rarely prompt children to say words, which is a surprise to many parents. But I don't need to tell a child to talk if I pick the right game and the right words, because the child will want to talk. Talking will make sense to the child.

Mom and I were both very excited when Aaron said these words. Reciting words (or saying words when prompted) is not the same as using words to for real purposes, like to narrate pretend play. I reserve excitement for the words children say for a real reason--to comment, ask, complain, refuse. I was excited to hear Aaron's words, because I was showing Aaron how to narrate play with words and he was giving it a try. Narrating play is a real reason for talking and it is intrinsically rewarding--meaning that the child is likely to say words for this reason without the adult praising him or giving him a reward beyond naturally responding to what he or she says.

I stuck with this routine in the game a while longer because I could see that Aaron was learning and I could feel that he was engaged willingly and happily in the game. But after a few more turns, Aaron apparently found the game too repetitive and started to lose interest so I had to add something to the game. I added a new play element Boots is tired, he needs a nap. Goodnight Boots. Go to sleep. Shhh! I saw that this play idea caught Aaron's attention and made him smile. He put Dora down on her back to sleep, too. So, I said, Goodnight Dora, Go to sleep! Shhh! Again, Aaron couldn't narrate the play with these new words, so that continued to be my job but when I did it well, with words he liked hearing, he was clearly more interested in the play.

As I explained to his mom, I had to watch everything that Aaron did, or else I could miss my opportunity to be the narrator so I stayed focused on every move that Aaron made in the game and added words when this would make the play better. I did not add words simply to be talking because talking too would cause Aaron to stop listening. The words were used so that Aaron could enjoy the play more. Just that.

Aaron and I made the characters take naps and go down the slide for several more turns before I could see that Aaron's interest was again waning. I continued to add little variations to keep Aaron playing with me. I don't keep games going though if a child has lost interest and I can't find a way to make it fun again. I sometimes misjudge and add the wrong thing. With Aaron, I tried to bring a Pooh Bear character into the game to slide but Aaron pushed Pooh Bear away and would have left the game at that point except that I said Go Away Pooh Bear! He did not like Pooh Bear included but he liked the idea of verbally sending Pooh Bear away! It was not long after that session that Aaron learned to say Go Away! I created a Go Away game before the next time he came because he had shown so much interest in sending Pooh Bear away.

One of the things that makes pretend play so much fun for children is the power that the pretend world provides. It is important to show a child how powerful he or she can be when pretending. For example, I thought that Pooh Bear might make the play more interesting but Aaron did not agree. Because I supported his idea of excluding Pooh Bear, Aaron successfully made a rule in the game--Only Dora characters can play on this slide today. He did not fully understand what he had done, yet, but I knew that Aaron was going to enjoy being a rule-maker in the world of play. We would go on to share and negotiate rule-making power in many a game. In fact, recently, when I played with Aaron and was able to ask him if he wanted to change the rule in a board game, he answered, Yeah, maybe you should write it down, Tahirih, because you always forget new rules.

Back then, when we first started, I remember our slide game as a great learning session. I could not know then how far Aaron would go, and we never really know that with any child. But I did know that on that day, we had both learned a lot--which made it a great day. I had learned to understand Aaron better, in part by playing with him and in part by explaining what I was learning and doing to his mom. The game might have looked simple, but it was not. Just by taking three characters up and down a slide and laying them on their backs, Aaron had entered the world of pretend play for the first time! The key to this amount of learning was repetition and routine and the gradual introduction of new ideas. Predictability was the hook that drew Aaron into play with me. Once in, the gradual introduction of new ideas allowed him to learn more and more.


I don't use straight drill work, which was a surprise to Aaron's mom, when we started. She was expecting something that looked more like school drills when she brought Aaron to me. But play with this much repetition is a close cousin to drill. It is the exciting and more powerful cousin. Emotions are not highly engaged when one is practicing language but emotions are highly engaged when one is using language in play. In pretend play, the child actually wants to use new communication skill in order to make something happen in the play. With Aaron, he wanted to talk because narrating the pretend play idea made it more fun. He wanted to learn to tell people and things to Go Away! both in pretend and in real life. In play, the child practices language over and over but everytime he or she is using language as a communication tool.

In pretend play, I discourage parents from using praise when the child talks. I don't want the parent to say something like Good Job talking Aaron! because it will interrupt the flow of the play. Instead, I encourage parents to respond, respond, respond! Good night, mommy! I said to Aaron's mom. Aaron said igh. She took our cue and laid right down beside Dora and Boots.

Please read previous post as the two posts are related.

Friday, June 6, 2008

Why I Think H.U.G.S. Science Will Improve My Therapy

Last week, I participated in a workshop called H.U.G.S. Science TM, which stands for Help Uncover Good Scientists. I am very optimistic that this workshop will improve my therapy practice in some important ways. Let me share with you what I am thinking.


An often recommended way to engage a child with autism is to use the child's interest as a topic of play, discussion or academic learning. Sometimes this is challenging, as when, for example, a young Temple Grandin (who is a well-known adult who has autism) became interested in cattle slaughter houses. She has advocated for taking anything that a child is interested in and teaching the child academic and social skills around that content area. For her, this educational approach resulted in her getting a doctorate, becoming a professor and becoming the world's foremost authority in designing humane slaughter houses. I think she is right to encourage us all to consider the possibility that early passionate interests, no matter how obscure or unusual, might end up becoming the foundation for an occupation or a highly pleasurable life-long hobby. Even in the short term, incorporating a child's passionate interests is a fast way to gain the child's attention and cooperation, so I have become pretty good at being genuinely interested in anything that engages a child. But I also believe that limiting oneself to supporting exclusive, narrow and obscure interests may limit the child's social relationships in childhood and in adulthood and ultimately limit a child's quality of life--a point made eloquently by Dr. Steven Gutstein in his book, Solving the Relationshop Puzzle. I have found it relatively easy, with many kids, to expand interests.

I use a kind of hybrid educational approach and do not limit myself to using the things that a child is presently passionate about even with young children. Instead, I use activities that I think the child would be interested in if only he or she had a little exposure. I try to expand a child's interests but I am realistic about what activities I choose, particularly early in a child's development of language and social skills. Traditionally, preschool toys and activities emphasize social/imaginative play, and are successful learning tools to the extent that the child has mastered a huge and ever-expanding set of language and social skills. Trying to get a child with ASD to focus when the content is so challenging is simply unrealistic for many young children. I have had great success, however, creating group experiences and therapy activities where the content is based on exploring the physical world. Once a child is pleasurably engaged in an activity with others, the language and interactions skills can be taught naturally.

I can't claim that physical sciences are a strong knowledge area for me. I can only offer physical science content because the kids I work with are so young that I still know more about physical science than they do. I have done enough therapy based upon this kind of science, however, to know that some of my most successful therapy sessions were sessions that involved physical science exploration. Marble Works, magnet games, water activities, and blowing feathers across the table are all standard games in my repertoire. I attended a H.U.G.S. Science workshop presented by a preschool science specialist, Joanne Burke, with some confidence that I would come away with good therapy ideas. Joanne has created a science kit filled with about two dozen homemade science experiments. Most of the materials are readily available, although I would not have come up with the combination nor thought of so many ways to use these things. Joanne modified her regular workshop for a small group of Speech and Language Pathologists and focused her discussion on the link between developmentally appropriate preschool science activities and facilitating growth in language and critical thinking skills. Developmentally appropriate sciences for young children, she explained, are cause/effect sciences that always allow the child to initiate an action, observe immediate results, repeat that action, or try something new. There is predictability in this science that immediately hooks the child into participating and helps the child begin to think in new ways. Many of the experiments that we learned were about things that move and things that change--physics and chemistry. From a child's perspective, though, H.U.G.S. experiments are also sensory treats. Objects spin, are launched, slide, tumble, race, fall, wobble, hover, float, and sink. Liquids flow, drip, blend, squirt, gush, are sucked in and poured out. Colors, sounds, textures, weights, sizes, and shapes all come to have meaning and play a part in simple but dramatic experiments. I hope you noticed the rich vocabulary potential suggested above. Vocabulary embedded in this context is interesting, useful, and concrete in meaning. For the highly verbal child with ASD, I predict that the precise nature of the language would be particularly engaging. H.U.G.S. science is not about providing a child with a collection of facts--it is a means of integrating experiences with language and critical thinking skills. I believe this kind of science will motivate many of my young friends with ASD to initiate, observe, analyze, predict, wonder, tell, ask, remember, and generalize what they have learned. That is what I am hoping, anyway.


Over the summer, I will try and then record the therapy usefulness of H.U.G.S. experiments and get back to you on this. Here is one other thing about using these materials that I feel excited about--I often have trouble finding activities that dads feel comfortable doing with their child. I am so happy after sessions where I see a father totally enjoy what he and his child are doing. I can predict, based on past experience, that the experiments I saw in this workshop are Dad Bait. Increasing my repertoire of father friendly activities is very cool. Notice the wooden piece in the picture below. It is called a Launcher. It is easy to imagine the average dad popping items into the air with a launcher, isn't it?

To contact Joanne Burke if you want her to present her delightful H.U.G.S. Science TM workshop to your group or to purchase one of her science kits, you can email her at joanne@hugsscience.com

This post has been submitted to the All About Parenting Blog Carnival at About.com Parenting Special Needs

Thursday, June 5, 2008

Can This Child Participate In a Bear Hunt?





Here is a question that I was recently asked:

Tahirih, I have a question please. I am working at a clinic and we have a classroom that has several autistic children in it and once a week we try and take a group of around 10 children and we have several adults (2 teachers, 3 SLPs, 1 PT). When you have an autistic child (who is typically a roamer) should you insist he/she participate in group activity? For example today we read the “going on a bear hunt” story in their classroom, sang songs and did finger plays and then brought the children into the motor room where we acted out the story. We walked over the mountain, through the forest, under the bridge. You get the idea. Well the 2 “roamers” had a very difficult time w/ this and we need to know if we are correct in insisting they participate (w/ our help of course). Thanks for your input.

Hi B,

It is truly not possible to answer a question like this about specific children that one has never met doing specific things in an environment that one has never seen with people who have or don't have skills that would be important in determining the likely success. But I don't want to turn down what is a good question so I will answer generally and not for your little roamers in particular. The ideas that I will talk about are elaborated in the SCERTS manuals under the headings that they discuss as Emotional Supports and Transactional Supports. I refer you to these books for more information and your team will, no doubt, come away with many new strategies and ways of understanding group intervention if you can spend time studying SCERTS.

In my practice, I prioritize emotional regulation for children with ASD meaning that I don't want a child with ASD feeling highly anxious or stressed for long periods of time or at regular times every day or every week so I don't continue, unaltered, anything that proves to be highly upsetting or causes children to "leave" physically or cognitively. That said, I also want kids with ASD to experience as many social environments as possible and enjoy time with peers in different settings, doing different things. So I don't believe it is a good idea to isolate children with ASD from peers until they are "ready" as there are no readiness skills that are an absolute barrier to social inclusion except maybe danger to self or others.


There are many ways to help a child with ASD feel safe and not confused in activities such as you describe but some reluctant participators may respond to an additional element of support in one day and others might need to be taught how to use a learning support over a period of weeks or months. For example, some children might participate in the Bear Hunt activity easily with just the addition of a visual schedule. Some might enjoy being physically supported and physically moved from one place to another and find it easier to listen and learn if taken by hand or placed in a lap. Some children might enjoy this activity if the Bear Hunt was pre-taught by going on the hunt the day before with just one person or by showing the child a video model of this story or the activity before participating in the group event. One of those relatively simple learning supports might just do it assuming the child enjoys and understands something about what is going on in the activity. This is a big assumption, by-the-way. Other children might not respond to one or another of these supports, period. For example, a child might be so upset about being touched and restrained that the activity becomes nothing but a wrestling match and as a learning activity it fails entirely. Some children might be able to use one of these or a different learning support in order to stay emotionally regulated during the activity and learn but not until the learning support is taught in a much simpler context. If a child has never used a visual schedule, for example, the child might need to learn how to follow a visual schedule first. It might be wise to teach the schedule in a context where all the activities on the schedule are understood and enjoyed. Yesterday, I started a child on learning visual schedules by making a picture list of:

1) Kiss mom
2) Eat chips
3) Hug dad
4) Eat French Fries

For this child, kissing, hugging, eating chips and French Fries are all really good things so the child will just be learning that lists have numbers, go down the page, and whatever is in the picture represents what will happen in the real world in a certain order. I want to use visual schedules to teach some other much more challenging skills, like participating in activities with others, but we will scaffhold one skill on another until the child learns and uses visual schedules to understand group activities. Learning supports might eventually work well but may need to be taught incrementally.

The other issue, hinted at above, is whether the child understands the activity in any meaningful way. Going on a Bear Hunt is not something that a young child has ever experienced so he or she can only grasp the idea of it through imagining what it might mean. This is developmentally a very advanced skill for many young children with ASD. I often ask myself some specific developmental questions when I consider an unsuccessful therapy activity like this. Are this child's language skills such that he or she could understand the words? Does this child have any pretend play skills? Are this child's pretend play skills such that he or she could pretend something he or she has never seen? Does this child have the ability to engage in brief social interactions of this kind? If the child lives entirely in the present moment moving from one sensory experience to another, does not show evidence of comprehending narrative language, cannot engage in brief social interaction activities and is made highly anxious in busy changing social environments, then the Bear Hunt activity is developmentally way above the child's comprehension and ability. The experience still might be pleasurable and an opportunity for social learning if it were presented to this child so that every part was really a sensory experience with elements of chant or music, exaggerated facial expressions, stomping, running, and so on but this would require more preteaching because the thing that holds all those sensory elements together for most children is the story. One has to imagine the whole experience with no story and see if it works as a sensory routine. In the You Tube clip that I have embedded above, the story teller is using sensory elements well enough that it might be captivating to a child regardless of the incomprehensible story content and/or an inability to comprehend the language. The goal for the child with ASD might be to increase his or her attention to faces, move together with others, or stay longer in a group of children. Pre-teaching elements of the activity might make this possible and even engaging for the child. The child might be given homework the week before of watching this and some of the other great You Tube videos of The Bear Hunt story prior to the activity in a group. Perhaps the child would not make it through the entire group activity but still use the Bear Hunt materials with parents and a single therapist in the same week as the other children are doing it and just watch the other children from a distance on the day of the event.

The learning goal for the particular child would determine whether or not it was appropriate to ask the child to participate in the group activity and to what extent. The outcome of each session would determine what happens the next week. If the child becomes increasingly skilled at tuning out the teachers, escaping the group activity or disrupting the group activity then rethink your learning goal and learning strategy. If the child becomes increasingly willing to participate and learns more and more while participating then you're on the right track.

The fun for me as a therapist is trying to find a way to make things work regardless of how many steps it takes. There is no single solution for all kids with ASD but instead there are many great solutions that make social interaction and communication possible. You must Go On A Solution Hunt and come back with a good one.






Tuesday, April 22, 2008

Teaching is not Telling

I have done taped interviews with parents from time to time, asking them after a year or so, what they have learned. I learn a great deal from these interviews. This morning, in our clinic waiting room, I was reminded of a particular interview. It was an interview where a mother told me that the most important thing she had learned was that teaching is not telling. I had not said this, at least not in these words so I was glad she went on to explain what she meant. She said that in her childhood, she saw adults tell kids what to do. She had learned that good kids did what their parents said. Good parents told their kids how to behave. Her intention was to be a good parent and to have good kids and her husband was right on board with this. So, they were nearly in despair when I first met them because their seven year old son ignored, disobeyed, and argued with them about nearly everything. They felt like bad parents with a bad child (whom they adored none-the-less.)

This mom was shocked when she truly began to understand that in order to teach her son to behave more appropriately, she had to show him, step-by-step how to behave. Likewise, she had to show him any new skill because he never learned new skills without visual demonstrations or some kind of visual support. She said her parents had never done this with her, rather they had just told her what to do and she had done it. Spanking might have been mentioned occasionally. She was shocked that she could not parent in the same way with her son and expect the same results. But she came to believe that her son really could not do what she told him to do, simply because she told him. This is the nature of the receptive language disorder most common in Autism Spectrum Disorders and in my experience, it is a very hard thing for parents to believe. It is really hard to believe, this mother said, when your child appears to understand language. Her son could talk, although when you listened closely, he was restricted in what he said, mostly to memorized language from books or movies but also many memorized argument phrases. Their son, like most the kids I see, used his memory to guide his behavior. He did what he had done before or what he saw done, not what he was told to do.

As she looked back on our year together, this mother remembered how hard it was to ignore the arguing routine that their son had perfected and respond to him with, Let me show you, just watch. They learned to move across the room to stand next to their son and demonstrate what they wanted him to do without saying a word in some cases. They also made lists for him (he could read and used written language quite well to guide his own behavior). They wrote stories and showed him pictures of what they wanted. If I had known how well video modeling worked, they would have made videos to teach him new behavior and new skills. These strategies were successful enough to be convincing but nothing was a quick miracle solution. Their son had seven years of coping by refusal under his belt. Over time, their willingness to show as a teaching strategy rather than tell as a teaching strategy resulted in less refusal and less arguments and more and more learning. Their understanding of their son changed dramatically. Their understanding of themselves as inexplicably bad parents changed as well.

As this mom, explained, we learn our parenting strategies early and usually by watching our own parents. In fact, we unconsciously imitate parenting behaviors even if we don't intend to do so, as when I say things that sound exactly like things my mother said--same words, same tone, probably the same knowing look on my face that drove me nuts when I was sixteen. I don't have autism, so I understood social hierarchies as a teenager and waited until I was a mother and had a teenage daughter before I imitated my mother's adult lecturing a teenager tone of voice and words. Kids with autism are much more likely to imitate the dramatic and powerful sounding language as soon as they hear it. Thus explains, the little girl in my clinic this week, who, when her brother told her he'd be right back, replied like a little queen ordering her servant around You will say, I will be right back, ma'am. Her brother grinned and told us that Mom's trying to teach her to be polite. Demonstrating behavior to a child with autism works even when you don't want it to.

The most effective teaching really is demonstrating, showing, modeling. Children, all children, but especially children with Autism Spectrum Disorders, will learn best by watching and imitating. At one level, parents know this but they don't always know how to use this principle. I work in a play-based clinic and parents watch or participate in every session. We play with kids in order to teach them new communication skills and it clearly works. Yet, I watch parents come into our waiting room, where we put out new and interesting toys every week and rarely do they play with their child while waiting for a therapy session. Most parents, if they interact at all with their child and the toys will slip into the role of director or corrector or tester. They do not sit on the floor with the toys and play but rather watch from the side to see that their child does not make too big a mess or get hurt or behave selfishly with another child. They might tell their child a few things about the toys and test vocabulary knowledge by asking things like What is this called? and What color is this? Parents behave this way because they long to be good parents and have good children. Telling is teaching in the minds of many adults because they saw their own parents fulfilling the teaching role in this way.

I was watching a new parent in our clinic interact with her daughter in the waiting room and starting to form an intervention plan this morning. This is when I remembered that parent interview where the mom said Teaching is not Telling. I knew that this would be an important new concept as I watched mother and daughter together. The mother had told me last week that the goals for her daughter were to 1) learn to play with other children 2) not be so bossy with everyone. This morning, the mother was sitting off to the side and asking her daughter questions about each toy or telling her daughter where to put each toy. Her tone was socially appropriate for a mother but would sound very bossy if her daughter imitated the tone with another child. Her daughter, although reluctantly compliant with the activity was not learning to play because what they were doing together was not playful. I knew, as I watched, that I will be gently asking this mom to rethink her role as parent, at least in regard to play and get on the floor and show her daughter how to play, how to be cooperative, how to share control--all the things she wants her daughter to learn. She has been telling her daughter long enough, now it is time for her to teach her daughter. Wish me luck. This is always a hard sell.