Safe Emergencies and Halloween

I have been thinking a lot lately about the concept of a Safe Emergency as I find ways to prepare children for Halloween.  Halloween is a Safe Emergency Holiday where many people have decided that it would be fun to pretend to be brave about all the scariest things in life--injury, death, spiders, dark nights, and walking up to knock on the door of houses where strangers live.  As odd as this cultural celebration is, it is not a stretch to understand a holiday like this.  This kind of a holiday exists in many cultures.  Even more common and similar is  the kind of pretend play that you see with seven year old kids on the playground of any elementary school. You be the terrorist and you go in the hills over there. I will be a Pilot and I will bomb you but you try to get away!  Apparently, children are prone to re-enacting whatever terrifying thing they hear about.  By the time we are grownups, our Safe Emergency play has become video games, movies, books, rock climbing, and so on.  There has to be a reason that so many of us choose to spend our free time in activities like this.  I call these activities  Safe Emergencies.

Possible reasons for Safe Emergencies:

1. We need to practice in order to be prepared to handle real emergencies.
2. We like the feeling of control over scary things that we get when we play.
3. We like the feeling of alertness and mental focus that comes when we are a little scared.
4. We learn important emotional regulation, empathy, imagination, language, social interaction, motor and problem solving skills by engaging in Safe Emergencies.
   

Sensory Room

Here is an enjoyable website activity that will allow you and your child to create a fantasy Sensory Room.  The sensory room has options like what kind of bubble to put in the bubble tubes and what kind of music to play on the boombox.  I am always looking at these things as context for some communication goal since that is what I do.  Here is my idea:  Have each person in the family create their own personal favorite sensory room.  Talk about colors, music, themes, and all the other choices comparing what Mom likes and Dad likes and sister likes and so on.  Print each fantasy sensory room out when all choices have been made. 

For some children this would be a joint attention game.  For others a turn-taking activity.  For still other, an opportunity to learn new vocabulary words.  For children with strong language skills, you might want to make a chart and compare and contrast the way each person was the same or was different from others in the family.  E.g.  Dad loves bats but Mom loves fish.  Mom and Dad both liked the star sky.  I would think of this as a Theory of Mind game because it illustrates for the child differences and similarities in the way different people think.

Playing Board Games Together

My daughter, Serene, and I had a lovely evening last week playing games with a family that I have known and enjoyed very much over the years. Serene lives in Europe, where she is the special education teacher at the International School of Belgrade, so she had not met the family. Playing games together was a perfect way to get to know the three children, age ten and younger. As we left, Serene said I did not know what to expect but that was so much fun! I think we forget how much fun structured games can be with such easy access to other forms of entertainment. Not many other forms of entertainment are as well suited to friends and strangers alike meeting and quickly enjoying their time together.

Playing board games is a great activity for many children who have ASD because these games are social but the social demands are relatively predicatable. Board games have clear rules including a way of starting and a way of ending. Many games challenge the mind but do not require completely open ended thinking--which is really difficult for most children (and adults) who have ASD. Some games rely on chance and once a child comes to understand how to enjoy games of chance, anticipation of a possible win is highly rewarding. Some games involve pretending but again, in a limited way which seems to make participation and, indeed, creativity possible for many children who do not tap into their own creativity often or easily. The challenge for children with ASD is to learn how to understand the game in the first place and how to enjoy the game regardless of the outcome.

I want to tell you about one game that Serene and I played for the first time because it was a great game for many children with ASD to learn. The game was Whoonu by Cranium. In this game, each player is given a set of cards that say things like-- the zoo, cabbage, golf, the library, driving. Each player then takes turns guessing what another player would like best from among the cards in hand. After a round or two, you add up your points and the winner is the one who made the best guesses about what other people like (or got the best cards). Since thinking about preferences, ones own and the preferences of others, is a good skill for children with ASD to practice, this is a mind expanding game you should consider if your child is at the right developmental level. The game inspired good conversation as we played it and I liked the fact that each person was the focus of consideration as others tried to think about what he or she might enjoy. As I thought about the game, I thought that for some children, learning to be in the spotlight would be the challenge and for other children letting someone else be in the spotlight would be the challenge.

At some point in your child's life, you may want to teach him or her to play structured games. Here is how I have done it. I start when a child has the verbal skills to be successful with a particular game but even then I consider that each social and emotional game playing skill must be taught incrementally and not assumed. I often work with parents to help them see how to break down the game and teach it little-by-little. If a child is very young or a game playing novice, I start with simple games that have some sensory pay off. Bunny Hop by Educational Insights is a current favorite early game for me right now. I start it with novice game players by just taking turns putting the bunnies in the right color hole and then pressing down the farmer, which makes most the bunnies pop out (this is the sensory payoff). I make my way over several weeks toward playing the game with the real rules. It does not matter how long it takes because every stage of learning to play a game can be fun.

One pitfall that you will have to work your way around carefully, when teaching a child to play games, is the problem of losing. No young child that I have ever met is a good loser. Losing well is a hard skill to learn and it takes time and lots of encouragement to learn how to do it. I try never to shame a child about being upset when losing because it does not feel fair to shame a child for not knowing how to do something that every single child in the world struggles to learn. Parents themselves have often been shamed for losing badly and so feel that it is shameful for a young child to have a meltdown when losing. It will go much better if you just accept the difficulty as inevitable, like falling down when learning to skate. No big deal, you should assure your child, it will get easier next time.

I usually introduce games without mentioning winning and losing at all. In the Bunny Hop game, for example, we just take turns and notice what happens. Oh! Wow! I got six bunnies and you go ten bunnies. Let's try it again and see what happens, I say as we finish a round. It is often hard to even finish a round at the start. Let's just put five bunnies in, and then pop them all out, I might say to a child who has difficulty at this stage even staying with the same activity for long. Next time we might put in ten bunnies. Step-by-step, we teach more rules and even more gradually we add competition, often by losing well in front of the child many times before expecting the child to lose at all.

Eventually, competition will help your child focus and become emotionally engaged in the game but only if your child enjoys playing the game and is not solely invested in winning. Some parents are great game playing teachers and they do helpful things like making funny disappointed sounds or faces when a turn goes badly (most children love watching a parent act silly). Some parents need a lot of support to even learn to enjoy games again, or for the first time if they did not enjoy games as a child. I know that there are many, many ways to enjoy one another in a family so if it feels too stressful, I give up on game playing--but always reluctantly since I know what a pay off there is if game playing becomes a regular and happy family activity. Sometimes, I have to remind overly competitive parents to hold their competitive nature at bay while teaching their child to play games and, in fact, some parents really need to tame down their own competitive nature, period, or no one in the family will ever enjoy game playing. As a parent, remember that you are teaching skills by example when it comes to the emotional skills of game playing. The purpose of highly structured games, just like other forms of play, is to have fun. Your challenge is to find the level of complexity that works for your child and then model genuine enjoyment while playing.

I don't believe that competition itself is bad, however challenging it is to learn, having watched how competition can focus attention and hone mental skills more effectively than almost any other system of social learning. Competitive games exist because they are designed to enhance social interaction, mental focus, learning, and enjoyment and they can work this way for children who have ASD as well as they do for others. The right competitive board game can provide a level social playing field where the child or adult with ASD has all the skills necessary to enjoy being with others and at the same time enjoy developing their own mental capacities. Step-by-step, I encourage you to introduce your child to board games and make them so much fun that your child will willingly ask to play these games for social entertainment.

Thinking Out Loud To Yourself--So Your Child Learns How

We learn to communicate with someone who listens--with mom or dad or someone who responds as though what we have to say is powerful, important and interesting.

Then, finding it useful and enjoyable to have a conversational partner, we move an imaginary one into our heads and our favorite conversational partner becomes ...well ...ourselves. From then on, the person we talk to the most is our mysterious other self.

This private speech is as important as it is strange. When we are telling ourselves that we need to get ten things done before noon and rattling off the list mentally--is it because we don't know the list? If we know it already, which we must or how could we say it to ourselves, why do we have to say it to ourselves? It turns out that we don't know things in a conscious and motivating way until we tell ourselves, and the whole list probably will not get done unless we keep reminding ourselves. We learn by talking things over with ourselves. We understand better by talking to ourselves. We feel less lonely because we talk to ourselves. We get things done because we talk to ourselves. This private speech is built, though, on a social construct. It is an internal conversation that we have and we learn conversation first with others before we learn it as an internal mental function--at least in most cases. Children who have difficulty with all things social, that is children with autism spectrum disorders, often have difficulty developing a functional private speech system because it does not come natural to talk things over with anyone--even oneself.

Often parents and others seem to believe that children with autism have typical ideas and thoughts and feelings about the world and that they understand what they want to say but just have trouble putting these ideas into words and saying the words out loud. Oh! If only this were the case! Children with autism can be very intelligent in mechanical ways, musical ways, numerical ways, spatial ways, artistic ways--but as hard as it is to imagine for those of us who are neurologically oriented 90% of the time to the social world, children with autism are often unable to install an imaginary conversational partner into their minds. Then, all the things that they need to think through with words, tell themselves to do with words, console themselves through with words--all these things are never said and never thought.

There is a period where many children with autism do start the process of installing an imaginary other--and we can tell because like all children, they start this process by talking out loud to themselves. This is exciting to see. But, listening in, as we can, we realize that the range and complexity of their private talk is impoverished--in other words, they don't use private speech for as many cognitive or emotional purposes as other children do.

The intervention for this is to think out loud. Model and demonstrate talking to yourself. Gradually, you model slightly more complex self-talk as you see your child catching on. You teach this skill by demonstrating the skill in ways that will be interesting and potentially useful to your child. Visual supports are helpful--draw pictures, write stories, demonstrate with dolls, stop video movies and make explicit that people are thinking things with words in their heads and using language to do this. By all means, teach your child what a talking bubble and what a thinking bubble are and use these to explain how you think about things even when you don't say them out loud. This process of teaching thinking about things to yourself is one that spans years and can't be put on a treatment plan and achieved in a few months.

Here are some ways that we use private speech and that you can model for your child.

We play with words--imitating phrases that catch our fancy, trying on accents, singing songs, creating rhymes and rhythms. My name is Mary, I'm a Fairy, not too hairy, I love Larry! We don't need a reason for making car sounds, or nonsense words--we just like them.

We express and regulate ourselves emotionally with words. Just breathe! we might say after a near miss on the freeway. Yikes! is my favorite word for when small things go wrong and nearly all the children that come and play with me say Yikes! before long.

We coach ourselves through things that have several steps or are difficult. Ok! Be careful as you do this we say as we set the top block on a wobbly stack of blocks. I hope you are seeing here how play is the cradle for developing self-talk. Like so many other things, though, a child with autism will not necessarily learn self-talk in play without a model for doing so.

Narrating imaginative play and taking roles within imaginative play are both learned in pretend play but serve us well through life as we imagine future scenarios large and small and play them out, taking all the important roles so that when we get to the real job interview, the real discussion group at the community club, the real funeral for our step-brother's wife--we can figure out what to say. We often need to get on the floor and play with children to teach them how to shift back and forth between play narrator and actor in the imaginary world we co-create.

Reading and thinking through stories and information in books is another kind of private talk that we can do out loud to teach our children how to understand a book. This book has Dora on the front. I bet it will be a story about Dora. These words by her mouth have bigger letters--maybe that means she is yelling these words. Dora had a good time at the library. I wonder if we should go to the library like Dora?

You will need to use language that is at the right level for your child so that your child can understand what you are doing when you model private speech. Use language that is only slightly more complex than your child's language level. Like so many important parts of teaching a child with autism--you as a parent are in the very best position to teach this skill. If you could read my thought bubble right now, it would say Parents get all the best jobs!

Here is a link to a recent study:

Private Speech and executive functioning among high-functioning children with autistic spectrum disorders.

Which Dinosaur is Your Favorite?

Today, we put wall stickers of dinosaurs up on my therapy room walls. Which dinosaur does Annie want? I asked my young friend, Jake. Jake did not check with Annie but told me she wanted a Velociraptor (I am making this up because I can't really remember who wanted what). You can say, What dinosaur do you want, Annie? Jake asked her, Do you want this one? and pointed to the Velociraptor but never looked at Annie. Annie is new to working with Jake and so she agreed that she did, amazingly, want that exact dinosaur. I suggested that she try to become more opinionated about her dinosaur preferences so that Jake would not be upset or confused when his peer play partners did not agree with him on every point. She did exactly that and Jake became more interested in looking at her as we played together.

Wall stickers are great for teaching children concept words like higher/lower, beside/between above/below/under, next to, way up/down low, too close/too far away, next to the ceiling, right by the floor, in the corner of the room, close to the door, too crowded/not enough....

Like any kind of joint art project, decorating the walls with wall stickers allows the child to see the meaning of concept words -- one set of wall stickers can probably teach your child dozens of new vocabulary words. Just redecorate the rooms of your house often with them.

For the child who is ready, as Jake was, this activity will also allow your child to experience differences in personal artistic preference. Learning how to stay emotionally regulated (calm) while another person expresses a difference in artistic preference actually requires a pretty high level emotional maturity. I know this because my husband an I had bare walls in our home for years before we developed the emotional maturity to explore enough options and negotiate mutually acceptable wall art. Jake did pretty well with this today, though. I wonder which dinosaur Annie likes best? I asked. Which Dinosaur is your favorite? Jake turned and asked her. He did not seem to mind at all when she picked a different favorite than his.

Teaching Jake to wonder what others like or dislike is just as important as teaching Jake new vocabulary --more important really because at this point I am sure that Jake will develop a good vocabulary. He is at risk, though, for not developing enough social interest--related to his own self and related to others. Annie left today more prepared to teach Jake about his own and her unique opinions, preferences, and interests.

Magic Tricks and Theory of the Mind

On my otherwise rather tedious trip home from Serbia, the long leg from Holland to Minneapolis, I sat across the isle from a Dutch Magician. His name was Leonard, and he shuffled cards in a way that I have only seen in movies before. His cards flew from one of his long hands to the other in patterns and shapes that caught and held my attention and this was before he started wowing me with tricks.

A Magic Trick requires that the perspective of the audience be different than the perspective of the Magician. The trick won't work if the audience knows or sees what the Magician knows and sees. I was a perfect audience for Leonard because I don't have a clue how card tricks are done. But watching these tricks with the delight that one feels when seeing something surprising and seemingly impossible, I wondered if there might not be some learning possibilities in magic for youngsters with Autism Spectrum Disorders (ASD).

Specifically, it made me wonder if teaching teenagers with ASD to do magic tricks might help these youngsters learn the concept of Theory of the Mind. The concept of Theory of the Mind is that we communicate with mindful awareness that different people will inevitably know, see, understand and even feel about things differently. We all accumulate knowledge through experience and our experience has been different--thus we each must try to guess what others know or don't know in order to communicate effectively. We develop a "Theory of Mind" regarding our communication partner and factor this into our communication with him or her. Many communication skills are based upon being able to predict accurately what others know, believe or feel. Many communication breakdowns are caused by not predicting accurately. We inform by building upon the knowledge that another already has and we deceive by exploiting knowledge that the other does not have. We tease, tell stories, negotiate--the list goes on and on, all based upon an ever changing perception that we have about what others know or don't know.

The cognitive ability to make good guesses about what others know is an important foundation for social communication and it is much harder for youngsters with ASD to learn. Deception is a particularly hard concept for many children and youngsters who have ASD. While this might seem like a good thing, it is not. Even phrases like "I fooled you" or "I tricked you" seem quite difficult for my young clients to understand--let alone understanding whether a trick was malicious or good natured. I use games like "Doggy, Doggy, whose got the bone?" and reenact chants like "Who Took the Cookie From the Cookie Jar?" to help young children get the idea of purposefully deceiving others. It turns out that knowing about deception from both the side of the deceiver and the side of the deceived is very important to social success. So, about now you should be seeing the connection between learning Theory of the Mind and learning Magic Tricks. Magic Tricks are socially endorsed deception.

Card Tricks strike me as particularly interesting for the purpose of teaching the concept of deception to youngsters with ASD. First, cards themselves have numbers, have visual patterns on their face that are interesting but predictable, and they all have the same size and look on the back. Materials with these qualities are what I look for in materials that will interest and motivate a youngster with ASD. These are youngsters who often love repeated visual patterns, numbers, and stacks of things that are all the same size. I recently watched a serious minded two year old stack cans from his kitchen cupboard for twenty minutes and his mom told me he would go on carefully studying each label and stacking by size for hours if she allowed him to do so. "Cool!" I thought, "We should have something to work with there!" Finding motivating materials and content is a core trick to good educational practice when working with ASD.

Card tricks offer a high probability for positive social interaction. I am always looking for activities that provide a clear and somewhat predictable role for both (all) participants in a social interaction. Potentially, the Magician can memorize what to say and what to do and the audience will probably say and do about the same thing in each encounter. I try to embed social learning into activities that are otherwise interesting, learnable, and self-esteem building and magic card tricks would fulfill that requirement for at least some youngsters with ASD.

The social learning potentially found in learning card tricks is 1) learning Theory of the Mind in both an explicit and an experiential manner--namely learning deception in a socially appropriate context. 2) learning an interesting way to initiate social interaction. When you start shuffling cards in an impressive manner, people will come to you to see what you are doing. The response is likely to be positive if you ask "Do you want to see a card trick?"3) learning to seek social admiration. Youngsters with ASD often experience way too much negative social interaction and may get in a pattern of seeking negative social interactions because these are the most predictable and familiar to these predictability seeking youngsters. Many need to learn ways to seek predictable positive reactions from others. I have noticed that youngsters who have musical or drawing or mathematical skills have a way to bid for social admiration. It stands to reason that those who have good fine motor and visual perception skills might find this same kind of positive social regard though learning card tricks.

So, somebody out there has probably got an intervention all written up about using Magic Tricks with youngsters who have ASD--but I have not read it yet. I invite you, my valued readers, to send me information about what you have read, have tried, or plan to try. Leonard, for example, if you don't find a meaningful life in the world Performing Magic, you could always open a school of magic tricks for youngsters with ASD. There is probably a Financial Grant just waiting for that idea.