1. Engaging Young Children with Autism Spectrum Disorders: 10 Steps to Success! Dana Childress, M.Ed. Partnership for People with Disabilities VCU dcchildress@vcu.edu

2. At 11:30, You Will Walk Out of the Door With: Information about Autism Spectrum Disorders New “tools” for your toolbox Confidence that YOU can make a difference in the life of children with ASD and their families Shining Stars 2010

3. ACTIVITY ACTIVITY Seeing the World Through The Eyes of a Child with ASD Shining Stars 2010

4. Definition: Autism Spectrum Disorders (ASD) Autism spectrum disorders (ASDs) are a group of related developmental disabilities…that affect a child's behavior, social, and communication skills. American Academy of Pediatrics http://www.aap.org/healthtopics/autism.cfm Shining Stars 2010

5. ASD Causes? ◦ Most cases – unknown ◦ Multiple types of ASD likely ◦ Genetic involvement ◦ In some cases – may see genetic involvement + exposure to some unknown environmental factor Shining Stars 2010

6. ASD Incidence & Diagnosis ASD 1 in 110 Children 1 in 70 Boys Age of Diagnosis 4.5 to 5.5 years old 51%-91% of children show signs before age 3 Shining Stars 2010

7. Characteristics of ASD Social Interaction ◦ Reduced attention to faces & voices ◦ Increased tendency for isolation ◦ Limited social engagement & responsiveness ◦ Less likely to show pleasure in shared interactions (joint attention) ◦ Less likely to imitate others Shining Stars 2010

8. Social impairment in children with autism violates typical parent-child interaction. Doussard-Roosevelt, Joe, Bazhenova, & Porges, 2003, p 104 Shining Stars 2010

9. Characteristics of ASD Communication ◦ May show less babbling, fewer words ◦ Less attention to speech & vocal imitation ◦ Delayed receptive language ◦ Less likely to coordinate joint attention, gestures, gaze, & vocalizations to request ◦ Less purposeful use of language Shining Stars 2010

10. The strongest predictor of the child’s future gain in language skills in our study was caregiver utterances that are not only synchronized with the child’s focus of attention but also undemanding in quality. Siller & Sigman, 2002, p 85 Shining Stars 2010

11. Characteristics of ASD Play ◦ Restricted interests ◦ Less purposeful play ◦ Less/lack of turn-taking ◦ Interest in parts of objects ◦ May show repetitive play, movements ◦ Play is less complex, less symbolic Shining Stars 2010

12. In children with regulatory and autistic spectrum disorders, interactive play uniquely addresses the core deficits of relating and communicating as no other approach can. Wieder & Greenspan, 2003, p 425 Shining Stars 2010

13. So HOW do we begin?? Shining Stars 2010

14. Watch, Listen, & Learn Step 1: Watch, Listen, & Learn Sit back and observe - child, parent-child interactions, the environment Ask the parent/caregiver about the child’s interests, likes/dislikes, what they do together, what makes the child laugh Purpose: Purpose: Find out about daily activities & routines to determine the context of intervention Shining Stars 2010

15. Oh…I See! Step 2: Oh…I See! Attach meaning to the child’s sounds, movements, and activities Describe what the child does Use short phrases, fewer words Initially - no expectation that the child must respond Purpose: Purpose: Establishes that activity has purpose & provides a language model Shining Stars 2010

16. Less Talking, More Doing Step 3: Less Talking, More Doing Follow the child’s lead but help him structure his play Use physical and object-based play to engage the child Use something the child is already doing or playing with Purpose: Purpose: Helps the child understand that interaction can be okay Shining Stars 2010

17. I Can Do It Too! Step 4: I Can Do It Too! Start by imitating the child’s movements, activities, vocalizations to enter his play Imitate without the expectation that he has to do something in return When all else fails, imitate! Purpose: Purpose: Develops synchrony between parent and child Shining Stars 2010

18. Your Turn, My Turn Step 5: Your Turn, My Turn Turn imitation into turn-taking by assuming that it is “my turn” Use the toy/object the child already has Closely observe and accept any interaction as the child’s “turn” Wait for the child to take his turn before play can continue but keep up the pace Shining Stars 2010

19. Your Turn, My Turn Step 5: Your Turn, My Turn Shape the child’s turn into an appropriate response (gesture, word) If needed, give 2-3 prompts then help him take his turn (fade prompts over time) Keep turn-taking going as long as it is fun! Purpose: Purpose: Encourages expectation that the child must interact Shining Stars 2010

20. Let’s See it in Action! Circles of Communication Dr. Stanley Greenspan Shining Stars 2010

21. Ta-Da! Step 6: Ta-Da! Use high intensity responses to get attention! ◦ Big expressions ◦ Silly faces Use anticipatory phrases to entice, prolong attention, and encourage turn-taking ◦ Ready…Set…GO! Purpose: Purpose: Encourages attention to face, gaze, and voice Shining Stars 2010

22. The Power of the Pause… Step 7: The Power of the Pause… Allow for processing time Create the expectation that the child must respond to continue to game Be prepared to wait… A little discomfort is okay but don’t wait for a tantrum Purpose: Purpose: Allows for processing time and teaches that communication is expected Shining Stars 2010

23. Rock the Boat Step 8: Rock the Boat Once you establish or recognize a play routine, gently change it so that the child must adjust and interact Keep up the pace of play Protesting is interaction too! Use repetition to practice the old and new routine Purpose: Purpose: Expands the child’s play & communication opportunities Shining Stars 2010

24. Wrap It Up Step 9: Wrap It Up Wrap new learning in something familiar Watch for the child’s cues If possible, help him do one more step of the new activity before ending Purpose: Purpose: Builds comfort with interaction and new learning Easy New Easy Shining Stars 2010

25. One Brick at a Time Step 10: One Brick at a Time Be patient and understand that helping a child develop his abilities to interact, learn from, and play with others takes time Interaction should be fun… look for the bright eyes, smiles, and laughs! Purpose: Purpose: Builds a foundation for effective communication, interaction, and play! Shining Stars 2010

26. Okay…one extra step! Shining Stars 2010

27. Parents Make the Difference! Step 11: Parents Make the Difference! Remember your role as coach & support Parents have the greatest opportunities for intervention Focus on how THEY can use these steps between visits Purpose: Purpose: Supports parent-child interactions within the context of everyday life…it works! Shining Stars 2010

28. The greatest sign of a success for a teacher...is to be able to say, "The children are now working as if I did not exist.” The greatest sign of a success for a teacher...is to be able to say, "The children are now working as if I did not exist.” Maria Montessori Shining Stars 2010

29. For success in science and art, a dash of autism is essential. For success in science and art, a dash of autism is essential. Hans Asperger Shining Stars 2010

30. Let’s put our minds together and see what life we can make for our children. Let’s put our minds together and see what life we can make for our children. Sitting Bull Shining Stars 2010