Since I began working in an education setting with children with Autism and their families, I have grown so much as a psychologist and as a person. I have been humbled by the extraordinary courage it takes for parents to take steps on the bumpy road of diagnosis, treatment and taking in the complexities of what the future might hold, both for their child and for the family. One of the many challenges parents face, is allowing professionals to take an integral role in this process. Often, families, in some ways, are forced to open their lives and their child?s interactions to a range of professionals, such as early intervention teachers and therapists, medical professionals, and agencies in the quest to help and better understand their child and their needs. As a new mother, I remember holding my first baby in my arms, imagining that I would be the sole protector, teacher and caregiver of my child. Initially, it was painful to even let another person hold my precious baby. Over time, I learned to share her with the world, but I will always remain protective and cautious. I often imagine this vulnerability magnified a thousand times for parents of a child with Autism.
Some parents feel obligated, some might feel even forced, to put their trust in others in the course of diagnosis and treatment. Putting your child on a bus, sending them to school, trusting that your precious one will receive the nurturing, care and support that they need takes remarkable strength and faith. No matter how many other people and professionals are involved in the process of coming to terms with the child?s needs and treatment, the parent remains the parent. Yet it is hard to feel a sense of control in a course that is so new and unfamiliar. It can feel lonely and overwhelming.
Although it may initially feel safer to isolate, reaching out for support and becoming an advocate for you and your child can make the difference in empowering your child and your family. In my experience, coming to terms with the road ahead is a process that finds its greatest strength and support in building knowledge and understanding through connections with others. Teachers, therapists and educational settings will come and go; however, you are the child?s greatest advocate and teacher for a lifetime. You help to bridge the divide between your child?s home and school environments.
With a spectrum diagnosis, it is important to keep in mind the saying, ?When you meet one person with Autism, you meet one person with Autism.?? In other words, each child?s symptoms and presentation is unique. Therefore, it is essential that parents, educators and therapists assess each child for their individual areas of strength and need to provide the level of support needed for that particular child. Early identification and intervention is key to a child?s optimal development. As an early childhood professional, I feel that early intervention and assessment are essential, but just as necessary is having the family be active members of the educational and treatment team for their child.? In order to have the consistency and carryover to optimally meet the child?s needs, it is important that educators include the family in the treatment plan, as well as giving the family an active role in informing the team. There are some basic interventions for children with Autism Spectrum Disorders that can be utilized both in the classroom and at home.
Basic Interventions for Young Children with Autism in the Classroom and at Home
Consistency and limiting input is essential. Neurologically, a child on the spectrum can become easily flooded by sound, activity, and visual input.
1. Limit language:
Provide your child with simple directives during routine. For example, when a child wants to go outside, ?First jacket, then swings.? Flooding a child with language, ?Johnny, want to go outside? It is such a beautiful day. First we are going to do an art project, then take attendance to the office. Do you want to go with me to the office or do you want to stay in the classroom? Let me get the attendance together?? The child lost you at ?outside.? At this point, you are likely managing a tantrum due to overload. Often extraneous language sounds like a Peanuts character, ?Waa waa waa.? ?Keep it simple and clear.
2. Routines:
Often children with Autism are rigid in their own routines but may have difficulty managing the expectation of the classroom environment. Providing pictures of simple classroom routines can help. For example, unpacking a backpack in the morning might entail presenting the child with a board with Velcro labeled First/Next. Under the First, have a picture of the child unzipping the backpack (independently, or hand over hand depending on level of prompting needed), and under Next might be a picture of the child?s communication notebook in the notebook bin. ??It is important to keep the sequence short and simple, prompting the child by pointing to each picture using no language whenever possible to avoid flooding the child. Another example in the school setting might be for transitions. The pictures of each section of the child?s day (actual laminated photos of the child getting off the bus, sitting at circle time, running on the playground, etc) would be presented to the child, for example, First at circle time, and under Then placing the picture of the child at music. This can be presented to the child just prior to a transition to give the child time to process the upcoming transition between activities. ?In the home, if your child has difficulty with the routine of going to bed, you might take photographs of the child engaging in the routine. The first picture might be of the child?s pajamas, then a picture of the child in her/his pajamas, a picture of the child brushing her/his teeth, a picture of the child reading a bedtime story with a parent, then a picture of the child sleeping in their bed.? The picture sequences can be even broken down more simply, such as separate sequences of each step. ?For example, with brushing teeth, first a picture of toothbrush and toothpaste, then toothbrush with toothpaste on the brush, running the brush under the water, toothbrush brushing the child?s teeth, spitting, rinsing and smiling in the mirror holding the toothbrush.
3. Mix it up:
It is likely that the child likes to do things the same way each time. It certainly is true that children need consistency and routine, however children with Autism tend to get stuck and rigid. For example, the child may only swing on the blue swing, only sit in the red chair, or only label pictures in order. This is not functional. Our goal is to increase appropriate and functional behaviors. Mix it up. I know that this is definitely not easier for teachers or for parents, in fact, this will likely result in screaming tantrums which will compel you to give in and let the child swing on the blue swing. For your sake and the child?s sake, mix it up. You can control the choices. For example, say to the child, ?Today you can sit on the red swing or the black swing (you may need to remove the blue swing). Or, ?First black swing, then blue swing.? Again, this can be prompted visually to avoid overloading with language. Remember: behavior always gets worse before it gets better.
4. Enjoy and celebrate the child?s strengths:
Sometimes it is hard to see the positives and successes can easily be overshadowed by the challenges. Take time to notice and highlight the things that go well, no matter how large or small. In the classroom, as well as in the home, a visual positive behavior board can work with young children. Planned ignoring, or intentionally not giving attention to negative behaviors, while intentionally identifying positive behaviors can be a wonderful tool.? Be specific when acknowledging the child, ?Johnny, I like how you are sitting in your chair!? Attend to the good behaviors and let the child know that you notice and are proud of her or his successes.
5. Get connected:
Education and involvement are the key to understanding and acceptance. This is a complex and challenging diagnosis which requires educators and parents to come together and address each particular child?s needs together. For parents, there are wonderful resources not only for your child with Autism but also for the family. There are parent, sibling, and grandparent parent support groups, as well as organizations and professional who can guide and support you on your journey. There are many existing support networks. Reach out to your local Special Education Parent Teacher Association (SEPTA). Search online for Autism supports. Speak to the social worker or psychologist at your child?s school or reach out to the agency providing Early Intervention Services. Connecting with others is an essential step in processing the diagnosis and its impact. Although the terrain may at times be unfamiliar and rocky, both for educators and families, your openness to awareness and support from others may act as your guide.
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Dr. Sarah Woodward with her family
About the Author: Sarah Woodward, Psy.D currently works as the Supervisor of Psychological Services at Just Kids Early Childhood Learning Center, serving preschool aged children with special needs and their families. As a NYS licensed clinical psychologist, Dr. Woodward provides child, adolescent and family psychotherapy, supervision, diagnostic evaluation, consultation and training to individuals, both in schools and in private practice. She lives in New York with her husband and daughters.
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