Autism Help

When is an orange an orange? When is an orange a piece of fruit? How do I know it is not a piece of meat or a rock from a strange spongy planet?

An orange has its own unique characteristics, it is round, smooth with pocked indentations, it is the color orange. An orange inside out is juicy, wet, drippy sticky, pulpy, stringy and sweet. An orange smells like an orange and nothing else that I know.

I can throw it, eat it, squeeze it, peel it, smell it. I know an orange through all of my senses.

Cue selectivity is attending and perceiving the relevant characteristics of objects, people or events within the environment. Not all at once, at one time together, although sometimes altogether…then I miss something. Too much incoming stimulus – information to process all at one time. 

Cue selectivity teaches the learner to identify one cue and to gradually expand and add information onto the cue until the cue becomes a whole complete concept or idea, like an orange. The experience of the orange is fresh in my mind when I think of it because of my experience of the orange, because of my exploration of the orange through all of my senses, and because somewhere in my childhood someone taught me to label it as an orange, and because every one I have seen with an orange has named it an orange, and because I have had many experiences with oranges throughout my life time.

Now we are talking about the multi-modal experience, repetition, and the idea of learning through experience. I can touch, see, smell, taste, and if I listen very carefully I may be able to recall the sound of the peel pulling away from the fruit. Ours senses are a direct connect to the information processing center of the our brain.

Left in isolation, I may have invented a new name for an orange; if my senses were altered and my sense perceptions were altered my experiences might be different than yours. I might not be able to describe my experience of an orange to you. If I could not communicate and describe my sensations my lack of common language, or language as a common denominator,  I might be isolated from the social connectedness of my immediate community.

Cue selectivity is imperative when teaching children with autism.  It is important to meet them where they are and what they understand, to bridge the person with community and the community with the person is one long term goal. Meet them half way, on their terms first.

Impulsivity, what does it look like for a child with autism? Quickly grabbing items from others, opening and closing cupboard doors, getting desired things, items, and objects from others and storage areas without asking, running out the door to move through the hallway – run, jump, or bounce down the hallway. Taking things for an activity before it is the designated time to do so. These children are often very active, in motion, and moving very quickly. They seem not to be able to control their behavior. If they want it, they take it.

Often teachers and parents find this behavior annoying and disrupting to instruction, however, this behavior leaves the opportunities to develop communication wide open. It provides opportunity to teach the child to request access to items he wants or desires, opportunity to teach time management and self regulation, for example teaching the concept of wait…I am busy I will be with you in a minute.

Unfortunately, this often involves placing locks on otherwise free opening storage cupboards, child proof handles on doorknobs, and creating an inventory of communication photos, pictures, and or words to support the child in requesting items they want. This involves identifying and creating pictures of desired and undesired items that are in the cupboard and placing them on a choice board or choice page. This also might involved labeling the cupboard for the child to know what is in the cupboard and what items he or she can have access to.

Labeling the cupboard could look like  a broad category label system, color coding system, a number coding system  and combinations of labels and codes. This is the green cupboard all items in the green cupboard are related to classroom materials needed for academic activities. The communication pictures used to develop the skill of requesting the item and slowing the child down can be set up on a choice board that is kept in close proximity of each cupboard within the nearby area of the room.

An example of beginning to create opportunities for the child to request at home might be with foods in the kitchen. Picture cards are secured to the refrigerator with velcro  or attached with a small magnetic strip. The child is required to pull of the picture of the item that he wants, find an adult to request the item e.g. giving the picture to and waiting for the response, the adult can either affirm or deny the request. If the child has the ability to independently retrieve the desired food item after requesting, using communication,  he is encouraged to do so, or the adult can accompany the child to the refrigerator to retrieve the food item.

Many people view independent behavior as the ability for others to do for themselves. For a person with autism this can lead down a path of undesired routine and behavior. Retrieving items of desire, independently,  may not be accepted in all environments and can create  power struggles with others. Impulsivity over time can be replaced through teaching and using appropriate communication consistently and teaching self-regulation to put off immediate gratification.

Many people with autism exhibit what is called Theory of Mind behaviors.  This means that they lack the ability to naturally realize that other people have thoughts and feelings that are different from theirs. They lack the ability to take on the perspective of others or to empathize.

Most people learn this naturally through social interactions through the natural course of development. People with autism need to be taught about the feelings and perspectives other people have.

One of the larger complications this leads to is social understanding. The child with autism may not recognize the subtle cues of facial expressions, vocal tones, body posturing as they relate to the expression of feelings. Not to mention the use of language and its subtle nuances, metaphor and idioms. Children with an ASD more often are very literal cocrete thinkers.

How can I help this child? There are several ways to start. One might be teaching using cue selectivity to teach the subtle change in facial expressions. Using a hand mirror begin by making faces with your child, identifying the facial feature and pairing it with an expressive emotion. For example, when I  frown it is telling you that I feel sad, make the frown face exaggerate if necessary, trace the curve of your lips, draw the curve of the frown on the paper onto a blank face. Require or help the child make the same facial expression, draw the facial expression, write the word.  Practice it daily and begin adding additional exercises to it, stories about sadness, role playing, and try to help your child identify situations in which he has felt sad and write a personalized story about it, make it real.

Remember to focus on one cue at a time and then gradually build in one more cue at a time until your child has a whole picture of a person with the sad face. Focus one one cue at a time and pairing it with the emotional content is imperative. Keep language concise, clear, and precise. Utilize multiple modalities to engage the child into learning.

Do you own a suitcase filled with the “Shoulds”when it comes to being in public with your child with an Autism Spectrum Disorder?

The shoulds are a large external family of social dictates that tend to rule internal social expectations. The should family is usually comprised of the social perspectives of others. The should family has influenced our socio-cultural behavior since we were young children and depending on how and who we have become as adults the “shoulds” still seem to regulate our behaviors from a deep internal fortress.

You should not take your child out in public, you should feel embarrassed when he has a meltdown, you should not cry in public, you should not express your feelings to total strangers, you should wear an orange hat with a purple fishing vest and carry a large banana to call home to mother! Should you? Should you be listening to the ancient and current dictators of ”should” telling you who and how to be and when to do it? Should you? I challenge you!

Who determines your response to a new and different set of behaviors from your child? Who prepared you to accept and love a child that is so different and unusual than anything you have ever experienced? Who prepared you for the child that does not seem to blend into any setting you live work and play in?

Who? most likely no-one. But it is okay. You are with the most unique and special gift you have been given in life. Your child is amazing!

Why let others and internal guardians of the “should” fortress indoctrinate you and tell you how to think feel and act? I am not telling you what or how you should do things. I am inviting you to take a personal uncomfortable risk, take a challenge to do and think and feel differently, invite a new internal voice that asks “how can I do, and see differently”, what do I need, what does my child need and how can we achieve it together.

I invite you to develop a new system that challenges, educates, the existing belief system of the social dictates of the “shoulds”.  Educate yourself, your family, your immediate community on the very unique needs of your child and best practices for your child.