The Disposition to Communicate

Communication is not simply a set of speech and language skills, it is a complex social behavior that occurs or does not occur based on a number of factors. I have been thinking about this lately and trying to sort out the important factors that keep me communicating with others or get in the way of communication.  Extrapolating from my experience, I am thinking also about what keeps children with autism communicating or not.

It is clearly not enough to have the skills of communication--we also need the disposition to communicate.  Can I say hello to my neighbor?  I have the skill but I might not always use the skill.  If my neighbor is friendly and talkative and I enjoy talking to the man, then I greet him when he and I both walk out of our door at the same time in the morning.  If he is not friendly or does not say much that is enjoyable for me to hear, or is downright unpleasant in some way, or if I am late to work or preoccupied with something pressing, I might actively avoid greeting him.  If, everyday, my neighbor and I have acquired the habit of just saying hello, and then waving--then this routine will hold despite a lack of time, real social interest in one another, or any other factors that might increase or decrease my desire to communicate with my neighbor.  Little communication routines keep social connections alive if not vibrant.  If I really, really enjoy talking to my neighbor, and it is clear he enjoys talking to me too, then I might start to gather topics of conversation throughout my day that would interest him in our regular morning conversation.  If he likes politics then I might scan the headlines in the paper over breakfast for political news and during the day, I will remember political comments that I hear at work to repeat to him the next morning.  I might do this even if I don't particularly like the topic of politics because the social relationship is what is really motivating me. It is useful to think of all these factors and how they influence how much and to whom we speak.

I got thinking about this because recently I have lost my disposition to blog. Daily blogging is not so different than having a daily conversation with a friend or neighbor.  I write blog posts with parents and other professionals in mind because these are the real people that I talk to all day.  My other conversational partners are the children that I see each week.  With my blog posts,  I rehearse and clarify the topics that I want to cover in real conversations.  I think about how and why communication and social interactions work or do not work by posting on these topics.  Sometimes, I use a blog post to say things that cannot be said to the real people that I talk to because it would not be wise or tactful yet I want to say these things.  I guess you could say that blogging is a form of talking with one's self but it improves my communication with others in my workplace.  As a bonus, I have actual readers of the blog (or at least I used to have when I used to write.)  So, why did I lose my disposition to engage in this form of communication?  Because my mind was largely occupied with other things than work in the last weeks and months.

My disposition to think about and communicate about autism has been superseded by my disposition to think about and communicate about weddings.  First my youngest daughter got married at the end of July and no sooner was that accomplished than my older daughter announced her engagement.  My mind seems to be preoccupied with things like guest lists, wedding dresses, flower choices, and reception menus.  You, dear readers, if there are any of you left, should be grateful that I spared you all of that.  But I have been and am enjoying it hugely.  Just one bit that I will share about the upcoming wedding--the next wedding will be in The Netherlands!  I just got back from a two week vacation there where we did some seriously focused wedding planning and some seriously fun recreating too.  I am a little more distant from the planning of this wedding, though, so perhaps I will recover my disposition to write blog posts.  Actually, I am certain that my disposition to write blog posts will return sooner or later.  Meanwhile, for any reader who is focused on teaching a child with autism to communicate, let these be the take home messages from this post:

1.  Spend as much time developing your child's disposition to communicate as you spend teaching your child new communication skills.

• This means making sure that there are interesting, responsive, frequently available communication partners for your child--including you, of course.  Try to see communication situations from your child's point of view in order to become a more interesting communication partner.
• This also means making sure that people are not doing things that would make your child actively avoid communication-including you doing these things, of course.  See all communication situations from your child's point of view and you may see why your child actively avoids becoming engaged at times.

2.  Parents often say "My child communicates when he/she wants to." with the implication being that the child inexplicably does not want to communicate very often.   There is always a reason why someone is not communicating.  What is your child preoccupied with that gets in the way of social communication?  The wedding season will soon be over at my house but you may want to look at some of the socially isolating things that preoccupy your child and decide if these are temporary interference or if these things will permanently interfere with your child developing a disposition to communicate.

3.  Little routines of communication, which don't take a lot of time or mental effort, can keep a child connected socially even when things like exhaustion from starting a new school year, preoccupation with anxiety about something new, or a new passionate interest seem to be getting in the way of more active communication.

4.  The complex system that keeps us communicating or inhibits us can be altered intentionally.  You can alter the social world around your child and increase his or her disposition to communicate. 

A Change is as Good as a Rest

I am not working this week or at least I am not seeing children or going in to work--I am on vacation. So, what does this vacation look like for me? I am not traveling--my preferred vacation activity. My husband is experiencing the economic downturn personally and not working so travel seemed unwise. I must say, however, that spending the days at home is lovely, too. We are doing house projects. A change is as good as a rest, my grandmother used to say.

I always feel compelled to reorganize cupboards and drawers and that sort of thing if I stay home on a vacation so, today, my kitchen looks torn apart. One thing kind of leads to another with big cleaning projects. Sometimes, I get overwhelmed at this point when the room I am cleaning looks twelve times worse than it did before I started. Not today. I have faith that the kitchen will look better in the end and this messy middle has not caused me to doubt as it sometimes does. In fact, there has been an almost meditative quality to much of the day. My mind is busy, but lightly as opposed to the intensity of my typical mental day.

I love the work that I do but there is nothing restful about it. Playing with children who have autism is highly focused mental work for me. Part of why today feels restful is simply because it is different from my usual day, as my grandmother suggested. There are other reasons why it feels restful, though. I brought a very low pressure mental attitude to the project. I don't really care if it takes me all week to reorganize this kitchen because I have all week. I have stopped to eat good meals, to dance in my living room when the music compelled, to take a walk with my husband, and I even took a nap this afternoon. I enjoyed the simple tasks of wiping down cupboards, placing things in one place or another and cleaning the vegetable crisper but I also walked away from the project without guilt each time I wanted to do so.

Thinking about what makes an activity feel intense versus relaxed made me wonder about how children experience time with me. If I typically bring an intense mental energy to my work, do the children also feel our time together as intense? Is that bad or good? Should I be mixing intense mental activity with relaxed activity both for myself and for the children--and how would I do that if I wanted to? I think I will just go meditate on that question for a while as I move all my tea to a different shelf in the cupboard.

Reset the Button

After trying several different ways to inspire some cooperation in a child who resisted playing the first few games I brought out, I finally hit upon a game that he loved. He and dad and I then played happily and productively for twenty minutes and the next game went well too. The child’s father, apparently having had a pretty hard day with his son earlier, commented that as a father he just had to hit the reset button more often.

It is relatively easy for me to hit the reset button that this dad was talking about, but I remember when it was not—back when I had only worked with a few children with autism. A parent is in a totally different situation than I am. For one thing, most the time the parent has only worked with one child who has autism--their own. There several reasons why it is easier for me to hit reset emotionally and try something new than it is for a parent. 1) I know a lot of games and strategies and figure that sooner or later something will work 2) I can almost always recall that I was ultimately successful with a child who was equally or more challenging than the one that I am with 3) I don’t take it personally when a child is uncooperative because children with autism all have difficulty with social interaction so I know it is about the autism 4) I only have each child for one hour and then the child leaves so I always see an end point no matter how hard a session gets. None of these things is true for the parent of a child with autism and parents feel the strain. None-the-less, to be successful parenting a child with ASD, a parent needs to know how to hit the reset button.

I mention the factors that make it easier for me, in part because parents can use these factors and others and make it easier on themselves when they need to hit the reset button. They can learn more games and strategies--giving themselves a bigger tool box and confidence. Parents can read about other kids with autism and know that others are equally challenging (or more challenging). They can increase their own patience by reading success stories. That is why I include so many stories on this blog so that parents see a success when it happens and anticipate success when it takes a long time. Parents can decide emphatically not to take their child's behavior personally and reset the button with that thought. Parents can set reasonable time limits for play and activities. Play for a half-an-hour or one hour and then stop and come back to it later after your reset button is naturally reset.

This idea of learning how to hit the reset button extends to children as well. I played with a little boy yesterday who was drumming with me. (Drumming game is demonstrated on this page.) I was following his lead and copying everything that he did. He enjoyed this so much that he sometimes fell over on the floor laughing and at one point, he took the drum sticks and starting hitting me with them! When I redirected him, he tried to follow my lead for a bit, drumming in the same way that I was, but suddenly, he jumped up and went to my window blinds and started rattling them, looking at me with a clear expectation that I would scold and stop him. He was overly excited but not angry or mischievous as he gazed at me expectantly. He did not know how to calm himself down so he went to rattle the blinds, which is a behavior I have seen many children do in order to communicate some need for adult intervention. In this case, he seemed to want me to reset his emotional state button. The excitement he felt was too extreme and did not feel good. I did not react to the blinds behavior since I didn't want it to become the way this little guy communicates with me but I distracted him and helped him move into a more calming activity. With my new and helpful phrase, I told myself we need to find some appropriate reset the button strategies for this little guy.

Strap Me Down and Take Me to the Hospital!

Andrew was not very cooperative today. Andrew announced that he did not want to come in to see me at all when they pulled into the parking lot. Not a good sign. He has been prickly all day, mom said, helping me resist, temporarily, the tendency we all have to take these things personally. But it continued to be hard to get Andrew engaged in play and I let self-doubt in when mom asked me why I was letting him control the session although she sounded more curious than critical when she asked. I floundered with an answer. Maybe I said something like I feel like I might push him too far and then it would take weeks for us to get back what we had last week. Who knows what I actually said but I started to feel inadequate. Again, she kept a neutral tone but she mentioned that she does not always have the luxury of letting him choose what to do. Valid point, I thought and I decided I needed to take a different approach. I started to prioritize compliance.

I began to exert a little more pressure on Andrew but I regretted it immediately. I felt Andrew's panic when I tried to keep him playing a game longer than he wanted to stay. The week before, I could keep him in a game after he had expressed a desire to be done for several more turns and even rekindle his enthusiasm for the game. I never felt any panic in Andrew while doing this. Valid point, Mom, I think, but I will need to problem solve this from your perspective at a later time. I went back to my original objective and tried to find a way for Andrew to participate willingly. In order to do this, I had to remind myself that I did not have to look like I was in control at all times and hopefully I would find a way to explain myself better when I was not so busy working it through with Andrew. Mom talked more, as the session went on about how she often just leaves Andrew to himself when he is like this at home and when she can. I guess I don't have the luxury of doing that, I told her. But it sounded like a reasonable strategy as each thing I tried seemed to alienate Andrew more.

In recent weeks, Andrew and mom and I have set up some great pretend play sessions where our pretend play characters engage in extended conversation and Andrew is right there playing cooperatively, flexibly, creatively. Today, Andrew seemed unable to comprehend even simple language and if I tried to extend a conversation for even a couple turns, he turned his head away and told me we were all done. I started thinking we needed a game with lots of sensory input because sometimes this kind of game improves language functioning and Andrew agreed to swing for a while. After a few swings, I tried a different approach to conversation--something more structured like I might do with a child who has far less language comprehension than Andrew does, or did, anyway, last week. I set up a routine where I would stop the swing every few pushes and ask Andrew to do something before I pushed the swing again. I started using very simple language. Touch your nose! Swing, swing, swing, stop. Touch your ear. Swing, swing, swing, stop. Andrew did what I asked for a few times and then said he was all done faces.

Andrew popped out of the swing and ran around the room a bit, stopping at a folded mat that was tied together with stretchy straps (pictured below). He climbed under the straps. Mom saw right away that he was pretending to be in an ambulance, strapped down on a gurney, on his way to the hospital--which really happened to Andrew last summer when he had a seizure. I wonder if he is about to have a seizure? mom asked, now caught up as I was in the mystery of Andrew's behavior. He has been going to the bathroom all day and that happened before he had a seizure last time. Like me, she was wondering if Andrew might have a very good reason for being unable to settle in and play.

I don't know how much more eloquent Andrew could have been in telling us that something was not right for him today. He started trying to tell us with his restless, chaotic behavior. In the end, he found a metaphor. Strap me down and take me to the hospital. I don't know how this story will go or if we will figure out what Andrew needs when he can't settle. My point in this story, though, is that I almost ignored Andrew altogether in my need to feel like a competent professional. This happens most often when a child who, like Andrew, seems like he should be able to do so, fails to comply with expectations. I should know better because I often end up learning a great deal and finding important ways to support a child or family after sessions that go badly. But, like everyone else, I can forget. After today, I am back at the drawing board, puzzling about Andrew. Right where I should be.

An Extra Layer of Protection

We adopted our youngest son when he was six years old. We were his second adoption but he had had a happy six years of life, coming into his first family when he was just days old. The tragedy that left him an orphan again was unexpected and very difficult on him but he came into our family bravely and now that he is grown, I would say that he has done very well emotionally. I was not so sure along the way. For years, our little guy would grab a shredded blankie that he had had from infancy and throw it over his head when he was upset. Sometimes, he just needed an added layer of protection. Containment. Another, thicker skin.

I thought about my son and his very important blanket this morning as I offered an unhappy little girl a body sock, which is a stretchy fabric bag that a child can climb in and put over his or her head or pull just part way up like a sock fitted up to the waist. This morning, my young friend cried when her dad left to get some coffee. She kept crying as she climbed inside the sock and then stayed in the sock as we played our next game together even though her dad had returned. Sometimes I think the sock works just like any other distraction and simply takes a child's mind off the disappointment or anxiety of a stack of blocks falling down, another child winning a competitive game, or Tahirih saying all done after an exciting activity. But Occupational Therapists talk about the body sock, weighted blankets, and tight fitting vests as providing a child with "calming weight" or "calming pressure" which may well be true because I have never felt more calm and relaxed as after a deep pressure message--so there may be a physical reason why these things help a child regroup.

Sibylle Janert convincingly describes a more symbolic psychological calming effect in feeling contained in her delightful book, Reaching the Young Autistic Child, in a chapter called Dangerous Holes and Feeling Contained. I reread that chapter again today and revisited Tim who cried for seven months whenever he was not firmly held in someone's arms and Harvey who would not take his coat off at school and all the other children described in her chapter who found ways to feel contained in a confusing world.

It is not hard for me to recall many examples of my own of an upset child seeking out a small contained spot. Net laundry baskets, cardboard boxes, cupboards; I have even seen children try to climb into my Little Tykes doll house which is much too small but certainly looks inviting to many a child. One child who could not participate in small groups in a classroom, started taking his turn like the other children when he was allowed to do so from behind the teacher's desk. He started out under the desk, yelling out answers to the teacher's questions, but gradually popped up more and more often and finally decided that he would just come out and sit in a chair. Which reminds me of how much better the groups that I have led worked when children sat on chairs rather than on the floor. Even the containment of a chair seems to help many children feel secure enough to participate. Chairs with the child's name on it are even better.

The point here is that regardless of why it works, helping kids feel contained physically and psychologically is like an extra layer of protection for vulnerable little beings. It is both an educational strategy and a human kindness to provide as much protection as a child needs.

Time Traveling Language

Learning to communicate differently with a child who has autism takes effort and time. This post would be very long indeed if I tried to list here all the ways that you might need to change the way you communicate. But here is a short list of commonly important verbal strategies:

Most young children who have autism need adults to talk less, talk about what the child is currently experiencing or knows well, use short sentences, use mostly familiar words and phrases, teach the meaning of new words and word combinations, and demonstrate meaning quickly when the child shows any behaviors that indicate confusion. Young children with autism work very hard to communicate intentionally. Adults need to wait long enough before talking to see if the child has anything to say--some of my young friends can take up to six seconds to organize an idea and say it even when responding to a question that is understood and familiar. That is, one thousand one, one thousand two, one thousand three, one thousand four, one thousand five, one thousand six.

Let us contrast all this to the way most of us communicate:

We don't work at talking or listening or understanding language very often. We don't even think about it most the time. We understand what others are saying so quickly that we don't always need to wait for the whole sentence and many informal conversations are made up of partial sentences and a lot of mind reading. We easily talk about the past, the present, the future, the imaginary, the emotional, the spiritual, the mundane. And we mix and switch what we say in a dozen ways for two dozen subtle social reasons with automatic variations for each of our conversational partners-- all without planning what we will say and usually without reflection after we say it. Examples:



I am just a little shook-up, you'll have to excuse me, but I almost got hit by truck on the freeway! I am still shaking! (8:30 am when a co-worker says good-morning)

I am just going to enjoy this coffee because it has been brought to my attention that my life could end at any moment--this could be my last cup for all I know! Did I tell you that a truck nearly blew me away on the way to work today? (10:30 by the coffee pot in the break room)

Those stupid truck drivers think they own the road. They don't let those guys get enough sleep, that's the problem. I almost got hit by a truck driver this morning on the way to work! (12:30 pm in discussion over lunch)

I just thank the Lord that I made it through today. I could have met my Maker personally this morning when a truck nearly knocked me into the next world! (in the driveway to the Methodist Minister who lives next door)

Well, Honey! I gotta tell you about my day. It started off dramatically when I was driving to work and, you know that spot where Aunt Erma lost a tire? it was right there that a truck moved into my lane and would have hit me if I had not slammed on the break. (to husband as he comes in from work)

You just have to leave enough room between you and the other vehicles as you drive because you never know when another driver is going to move into your lane. (when in the passenger seat with a permit driving teenage daughter later that evening)

And so on with topics that are emotionally engaging, like nearly being hit by a truck, dominating our conversational language.

Most of us use so much abstract, complex, time and imagination liberated language that when we try to make our language more concrete, simple, and here-and-now---well, we just can't. It takes practice to tame our time traveling, socially sophisticated, wordy, emotionally laden, abstract, imaginative and highly variable language.

Remember, even if you work hard and learn a manner and style of speaking that is both simple enough and yet engaging enough for your child--your child will need to work still harder to learn how to communicate with you. You can do your share of the work to become a good communication partner, can't you?