Fun Cutting-edge Social Skills Instruction in Young Children with Autism
Early social development is connected to early language learning. We need to make sure that the young child with ASD is engaged in learning, and that teachers and parents become and remain the happy and fun conduit for learning.
BY ALAN SCHNEE, PH.D., BCBA-D
Anyone who reads the research related to language and social skills instruction for children with an autism spectrum disorder (ASD) will find a dizzying array of targets such as learning to say "hello", "listening and responding", "initiating", "teaching play skills", "giving and accepting compliments", saying "please and thank you", "offering help", etc.
THE FUN IN FUNDAMENTALS: Using games teaches children to listen to what we say. And by mixing things up a bit, it helps to keep children on their toes and prevent boredom.
While these skills might seem arbitrary, one thing that underlies a discussion of social skills and related deficits in children with ASD, is that social skills intervention usually involves teaching children to do things in language. This makes sense. Language deficits are a primary characteristic in children on the spectrum, and language itself is part of the human social experience. Thus, to a large extent, considerations for cutting edge social skills intervention are necessarily connected to language. To learn a language is to learn a social practice.
EARLY INTENSIVE INTERVENTION
Early intervention for children with ASD is most often organized around language learning. In Early Intensive Behavioral Intervention (EIBI), the sequence and domains under consideration are largely language-based. Children begin by learning the names of things, attributes, prepositions, pronouns, and verbs, often in discrete and contrived ways in order to establish foundational abilities. Later, these abilities and skills can be synthesized and systematically engineered toward broader and more natural applications. There are several different stages in intervention. In the earliest of beginnings, one of the greatest obstacles to learning is the absence of shared attention and engagement with others. When I first meet with parents whose young child was recently diagnosed, most of them suffer in saying the same thing: "It is very difficult to engage my child". "I can't get my child to pay attention to me." And, if parents are able to "connect," it is often through fleeting eye contact, which most parents will say is difficult to reliably elicit. Parents will do almost anything to get their children to meet their gaze. But standing on one's head is not necessary.
SETTING THE STAGE: STRATEGIES FOR EARLY ENGAGEMENT AND LEARNING
During a recent consultation with a 3.5 year-old boy who had already been involved in intervention for over a year, one thing seemed clear. He hated instruction. He was there because he had to be, not because he wanted to be. He avoided looking at his teachers and frequently ran away from them. It was not fun for anyone.
So, we backed everything up. No more naturalistic teaching, no more circle time or play groups, no more activities he actively tried to avoid, no more discrete trials, no more anything until we convinced him that things would be better.
At this stage, intervention is about getting children to pay attention to us well enough so that we can teach them efficiently and effectively. It requires that we identify the thing or things that that would catch a child's eye and light them up. Once those 'eye catchers' are identified, most, if not all children will meet us halfway. What we do is to hold a preferred item in our hand and show it to the child. If it's the best item at that time, a child's excited eyes go to it immediately. We then track the item(s) to our eyes (between our eyes to be precise). As we track it up, the child's eyes come up to meet ours and the child receives the item. As eyes meet, children begin to also see our smiles and our excitement with them.
This basic 'social game', the terms of which are - 'you look at me and something terrific will happen' - is often a good starting point for building trust and engagement. It's simple for the child and easy to implement for parents and teachers. The 'rules of the game' also include our promise to pay attention to what the child wants and to assess what the child is willing to tolerate from us. We promise to not go beyond that. With those things in place, we find that we are soon able to insert a little something extra; a tickle, or a toss in the air, in addition to the child receiving the 'eye catcher'. As parents consider this earliest stage of intervention, it must be stressed that there is a profoundly important social dimension to the early work. Teaching in and of itself is a social enterprise in which there is an implicit contract.
"RELEVANCE:" A SPRINGBOARD TO TEACHING
As greater trust builds (children have come to trust that adults are sensitive to their unique tolerances and preferences) and enjoyment is established, it is often possible to introduce instruction. At this stage, information about what to teach is readily available in books and manuals, but one vital area of intervention does not receive much attention: strategies for establishing the relevance of others.
Once children begin to acquire early linguistic abilities, it is important to also consider what my colleague, Stein Lund, calls "Social Primacy" – that is, maintaining and establishing the relevance of other people. Children with ASD often miss this.
SIMPLE "GAMES" TO TEACH RECEPTIVE LANGUAGE
"Selection-Based Imitation" (SBI), can be used as a vehicle for establishing social awareness, language skills and learning readiness skills. There are many possible iterations of this 'game', but to illustrate:
The parent (or teacher) places an array of pictures on a wall. A corresponding array of pictures is placed on a child's desk (or spread across the floor, it doesn't matter). In this exercise, there are a number of things that a parent or teacher can say:
- • "Find the ball" wherein the child finds ball in their array.
- • A teacher can point to an item on the wall and ask, "What's this" or "What color it this?" Now, we change the 'game' a bit: We can point to something in our array and say:
- • "Find one like this" (which is the SBI piece).
In this case, the child can be successful only by paying attention to the thing to which a teacher or parent points. The child is required to use the parent or teacher as the point of reference. If we place an additional array on a different wall and move from array to array, the child will have to track us as we move around the room!
Using these strategies (games) teaches children to attend to us; to watch for what we attend to; to consider our position in space, and to listen to what we say. And by mixing things up a bit, it helps to keep children on their toes and prevent boredom.
A NOTE ON SCREENS
Everyone is talking about apps and technology as the next frontier in autism intervention. I have found that over-reliance on the use of modern devices with touch screens in order to teach language and social skills tends to play into social disengagement, and can render parents, teachers and peers irrelevant. While screen-based learning has its place, parents should be mindful of this potential side effect and remember that THEY, not a screen, need to be the point of reference in learning.
It is important that children with ASD learn to respond to contextual terms, such as this, that, here, there, him, her, she, he etc. When we say things like, "Put the block over there", or "Put that on his table", or "Get that and put it there", we not only expose the child to common language practices, but we also maintain the significance of "others" as they are the point of reference. The child has to attend to you and the context of the situation in order to know what to do.
Once a child knows how to match, parents can leverage this basic skill by using a "sequential matching strategy" to foster social awareness.
In a common example, a child has a pile of things near them, which need to be matched to a corresponding array of pictures on the table in front of them. Parents or teachers can "sabotage" the child's ability to complete the task by removing some of the items, forcing the child to ask the adult for the matching item. This natural and fun social game can get children to learn to ask us for things.
- It can be taken even further. Once a child asks for the item, we can direct the child to get it by pointing to its location:
- • "It's over there."
- • "It's under that table." We can also use language and pointing to direct the child to another person:
- • "Alan has it."
- • "Mommy has it."
- • "She has it." We can even enlarge these possibilities:
- • "Alan has it"… but Alan's not in the room and the child has to go find Alan. The possibilities grow with one's imagination.
THE CHILD STAR AS TEACHER
Later in intervention, as the child's linguistic abilities improve and they are able to use prepositional concepts, and/or color, shape and size concepts in rudimentary ways, we can contrive games in which development of social acuity is highlighted (as well as greater linguistic fluencies). Putting your child in the role of teacher (and then playing along as a student who does not understand) is a fun way to encourage the development of social acuity.
For example, ask a child to tell you how to build a block structure, with a sample block structure in front of the child. Such a scenario might look like this:
- • Child: "Put the little triangle in front of the red block."
- • Teacher: Places the triangle behind the red block.
- • Child: "I said, place it in front of the red block."
- • Teacher: Places it incorrectly again and asks "Here?"
- • Child: "No, here" and shows the teacher where it goes.
Here, the child has to pay careful attention to what you are doing, guide you and correct you along the way. In these kinds of games, it is a good idea to be as poor a direction follower as possible. The possibilities are limitless and fun, and this kind of feigned denseness can be used across many situations. Just remember, when trying these kinds of exercises: the child must be able to follow the direction "say" and echolalia can not be present because teaching the child to be the teacher is a difficult step before considering using this strategy for developing greater social acuity.
Early social development is connected to early language learning. We need to make sure that the young child with ASD is engaged in learning, and that teachers and parents become and remain the happy and fun conduit for learning. The "contract" for learning comes with our promise to remain sensitive to the tolerances and enjoyments of children. The social dimensions of teaching are many and establishing the relevance of others is a domain which requires consideration when teaching children with ASD. •
ABOUT THE AUTHOR:
Alan Schnee, Ph.D., BCBA-D is a clinician, author and public speaker on effective autism intervention for young children. He has been involved in teaching children with ASD for almost 30 years. He is the director of Nexus Autism Intervention Services in Marlton, NJ. He studied under ABA pioneers at Princeton Child Development Institute, and with Dr. Bridget Taylor at Alpine Learning Group in Bergen County. For more, go to nexusais.com