Be With Your Child
This seems like the easiest tactic and shouldn’t need addressing, but it does. Get on your child’s level. It means more than simply sitting there. Be present, in the moment. Even if your child will not make eye-contact, it’s okay. Sit on the floor and “be”.
Make Play Meaningful
If your child will not play with you, then play beside them. Don’t attempt to direct the play. You can mimic what your child is doing or even play something entirely different. If your child doesn’t like how close you are, simply move a little further away, but stay on their level. It’s a great way to begin building rapport, as well as, allow you to see “how” your child plays. Are they studying wheels on toys, lining up cars, grouping items by some sort of criteria, or picking a similar item over and over again? Look for patterns. The child will sense your presence and if you are consistent, you may begin to break into their “bubble” and begin to interact and use play time to help communicate and teach/learn new information.
If your child is banging the floor, try to mimic them. Make a rhythm. Get their attention, and then see if you can make the noise another way and see if they mimic you. You are attempting to turn a common behavior your child may have into a meaningful interaction. Think of this as the building blocks of communication.
Impede the natural flow of play. If your child is lining up cars, put another toy directly in the path. Say:
- “Uh-oh! ”
- “That toy is in the way! ”
- “What do we do?”
If your child smacks the refrigerator to ask for a drink, pretend not to understand. Act confused. Odds are your child will begin to point, pull, grunt…all of which can be the beginnings of communication.
Sit facing your child as you play. Even if your child refuses to look at you, they notice more than you realize. You can even sit in front of a large mirror so that they can see your face. Couple simple phrases and words with your facial expressions:
- “Oh no!”
- “You did it!”
- “What do we do now?”
However, it is important that you not do all the work. Try to limit your facial expressions as a response to your child’s own facial expressions. Exaggerate your expressions somewhat, but keep in mind that they should match the event. Take caution to not overdo it. If your child is startled, lower your voice and take it down a notch.
In Good Times & Bad
Getting on your child’s level applies to the melt-downs too, not just the fun times. I can’t tell you how many times I had to hold or restrain my child during a melt-down for his own safety, or simply lay beside him on the floor until the melt-down passed. I cried and prayed alongside my child. Sometimes it meant getting scratched, punched, head-butted, and more of the like.
Family and friends that were not accustomed to this type of situation sometimes found it unbearable and voiced contrary opinions. It’s hard enough for us to wrap our brains around as the parent and we with it day in and day out. Try to remember they don’t know your child like you do and are seeing only a quick snipit of his life as they rush to a premature judgement. It probably is shocking to see you get beat up a bit. They simply are basing this new experience on their own experiences, of which we know there is no play-book…and let’s face it; this is simply human nature. Try to remember, that unless you actually walk in these shoes we are fitted with as parents of children on the spectrum, you can’t really know the full gamut of what the experience entails.
If the presence of others become too distracting or uncomfortable, simply ask them to leave for a few minutes, until you are through the rough part. I can’t say that I have been very good at this myself. I know some parents can manage this with ease and I envy them. I have to be truthful in saying I agree with these stoic parents that nothing matters but the child in those instances. You have to forget about what anyone thinks in that given moment, and I did. However, I would be ingenuine if I stated that it did not affect me when the moment passed. All I can say as to how I get through it is, be human. Honour your feelings, don’t dwell on them, and plow on. No good can come from staying in the muck, burrying the hurt, or lashing out at others. I didn’t realize that this was the kindest thing I could do for myself. At first I burried my feelings until I realized that this just added to the emotional weight I was already hauling around every day. Permit yourself to feel your emotions so you can be more effective in the long run for your child. Odds are there are more fires to be put out that demand your attention anyway.
Just “be” with your child. Even if you can’t talk to them, let them sense that they are not alone.
Simple Consistent Phrases & Prompts
While using gestures and expressions to communicate is good, it is essential to speak with your child. Just because your child is not yet verbal does not mean you should be silent. Use this time to model appropriate language, but keep it simple. Speak with animation, but use simple and concise word phrases:
- “Where is the juice?”
- “Jane is hungry?”
- “Here’s the car.”
- “Take a bath?”
- “John is mad!”
- “Good boy!”
- “Time to play!”
Once you have a strong rapport and connection with your child, try to get that eye contact. If you find an interaction such as tickling, or touching cheeks, or making a toy do something fun provides a moment of eye contact…do it again. Capitalize on those moments. Once you have those moments, consistently provide the interaction only if eye contact occurs. Then, you build on the eye contact. If your child pulls you to help them get or do something, get on their level and speak in short statements. I often used:
- “You want help?”
- “Look at Mommy’s eyes” –pause- “Look at Mommy’s eyes”
- “You want a juice?”
- “Okay, here is your juice sweetheart”.
(If the eye contact is not met, simply play dumb and start over, as if you didn’t understand that they were trying to get your attention).
If you are consistent, you can begin to apply this to all your interactions with your child. It is still so effective to this day, even though our son is now verbal, he knows whatever is being discussed is a reality if he looks in our eyes. Only now he turns the table on us, and requires our eye contact to drive his major points home.
Physical Contact – Be Tactile!
Being tactile is a vital part of interaction. Touching is a natural aspect of children at play. A wide array of touching can be observed during a child’s play, from hugging to holding hands. Children that are on the spectrum usually do not mix into social groupings and as a result typically do not experience as much physical touch as their neuro-typical peers.
Once rapport is established, touch can be a fantastic way to help facilitate communication. Touch for praise, or even to reinforce eye contact. A firm press on the chest and back was helpful to our son when he was overwhelmed, startled by a loud noise or new situation, or coming out of a melt-down. A soft stroke of a cheek in a quiet moment helped to gain eye contact and reinforce a more intimate hug with Mom or Dad.
For the nonverbal child, using gestures/sign language is a bridge leading toward what we hope will translate into verbal communication. Your child may already use their hands to speak to you and you do not need to learn specific signs to teach to your child. Use whatever natural gestures/signs, like pointing, putting hands by your mouth to indicate food or hungry, palms together against cheek to indicate “sleep,” etc. Once the gesture/sign is established you can build on them. As with everything you do, be consistent.
Find Their Hook & Use it!
When you have established how to “be” with your child and you have studied them to the inth degree, you may begin to notice that there are some things that bring them comfort or interest them. For us it was first water. I noticed when he was in the bath, he was calm. I began to place him in the bath after extremely intense melt-downs. Sometimes more than 5 times a day. I also noticed that the deeper water was more effective. Eventually, we were able to let him stand at the bathroom sink and play with a few toys or cups. Yes, sometimes it was quite messy, but it worked. Even when he got to be big enough to swim, we got a blue above ground pool from Wal-Mart and he would spend about an hour a day simply walking against chest deep water…and the result was amazing. He was calmer and happier.
Sometimes it is what they play with, or how they play. At 2 years old, we gave our son some matchbox cars that were once my husband’s as a child for Christmas. No wrappings or bows just sat them in the carrier box and let him play with it when he wanted. He began to line up the toys and get lost in organizing and grouping them in lines. I noticed he would do it by color, then type. It was amazing. Then we took a trip to the store and suddenly, the boy who passes by countless toy aisles without a single care or glance was over the moon. He made such loud inhale and exhale sounds and even started looking at us and saying “Please” over and over that he attracted a lot of other shopper’s attention. Yes, we grabbed all we could carry and couldn’t get to the register fast enough. Yes, there was an unholy melt-down because we couldn’t get them to him to play with fast enough. But, WOW. This became a wonderful outlet for him. He was non-verbal and confused and angry about it. If he wanted to line up toys for an hour or so, we let him. We never kept him from doing this, even as heartbreaking as it could be to watch. Something in him needed it, so we let him do what he needed. Later, when working on transitions, or crossing doorway thresholds, the cars were key. They were the “hook” that we needed to draw him out.
Find their hook and use it.
Using photos and pictures to communicate was huge and life-changing for us. First, I placed a picture of a juice container and a milk jug in letter size magnetic backed photo sleeves on the refrigerator door. Then, when my son wanted to have something to drink, he would point to milk or juice when I prompted him to select a choice.
After the initial use of images, I started taking pictures of all of his toys, pool, settings such as room, bath tub, car, school etc. I even had my husband take pictures of my son eating, changing diapers, drawing, playing, getting in bed, getting in the car etc. I was able to use pictures to forecast events that were going to happen to help my son with transitions. I was also able to ask my son what he wanted.
Providing choices truly empowered my child, but I was also able to use it to shape his behaviors. For example, I could offer him the choice to change his diaper or take a bath. I knew he would choose a bath over diaper change and I wanted him to take a bath. By coupling the preferred event with an unattractive option, I was able to get my son to take a bath and he felt like he made a choice for himself. A win, win!
We made a board, (see images below with sample images-try to use your own photos if possible) and used it as a Choice Board and a Forecast Board. It was a plain large black matte board with nothing on it but a single strip of magnetic tape. We printed out the photos and laminated (covered with transparent packing tape) and backed with magnetic tape.
- When it is time for the child to make a choice, present him/her with the Choice Board.
- Use a simple phrase, such as “make choice” to indicate that the child can choose any of the options.
- Providing only 2 choices initially, and slowly increasing the number of presented choices as the child is better able to discriminate choices.
- The child may need to be supported through prompts to make a choice.
- Prior to event/transition present child with the board. We used a 3 images sequence of the event (ex: Going to the Doctors) I placed a photo for diaper change, getting dressed, and then car).
- Use simple phrases such as “we are going to change diaper, get dressed, and go to the Doctors/bye-bye.”
- Provide this board 45 min to 30 min prior to event/transition. Repeat the phrases and then put the board down and let your child continue with their play. Repeat this each 15 min interval, and 1 final time prior to executing actions with “We are now going to….”
- Begin to walk through the steps as you go through them repeating “…change diaper…yay. Let’s get dressed…good job. Time to go to the Doctor/bye-bye…here we go.”
It’s important to be consistent and patient. I had been using the board with my son for a few weeks. At the time he was 2 ½ years old and not making much eye contact. He acted as if he could not hear a word I said. At one particular final forecast prompt, I broke down and said out loud in a conversational manner to myself, “I don’t know why I am even doing this, you don’t understand anything that I am saying”. The most amazing thing happened. My son walked over to me, took the board, threw it across the room, and laid down on the floor with his feet up in the air for a diaper change. I was in shock. He had never made eye contact throughout the entire event. And there was nothing pretty about the outing either. But, just that one act, shut me up and kept me going for the next few years. I would think about that single event when times got too tough to take and it would remind me to keep working whatever problem we were having at that given moment.
Use a Photo Book
Create a book of photos for your child when they want to communicate what they want and encourage them to use it. We also created a photo book for our son to take to daycare that had pictures of himself and me and my husband. At times he was able to use the book to calm down when distressed in the educational setting. He also used photo books (images printed on pages from our home printer and bound together) to prepare for an event such as going to the beach or starting a new school. Sometimes the images are generic, sometimes we visited sites and took actual pictures. We also provided images of common items related to the given event, so our son could color them and we would read through it like a book and discuss together.
Once in an educational setting with support staff, your child may use the PECS system based on images.
Resources and Links to consider: