I shared some of my favorite Halloween books last week and have used them when working with kids with typically developing language as well as those with auditory processing difficulties, and those on the autism spectrum. I had quite a fun time with Aaaarrgghh: Spider! with a little fellow on the autism spectrum that I wanted to share.
Our goals include being attentive to a book and answering wh-questions as well as building pretend play skills. It all came together with this goofy book about a spider campaigning to be the family pet! We started out with my wonderful collection of bugs, including spiders, a jar with a magnifying lid, Play-doh of course, and some little Fisher Price furniture and playground items.
We talked about the spiders, chose different ones to look at under the magnifying glass and then read the book. I pointed out the faces of the family and reactions to the spider’s attempts at winning them over. We copied surprised, scared and happy faces. Then we got out the Play-doh and made a web, stuck the flies and bugs in it for eating, and hung the spider down from the web to dangle over our dinner, as in the book. We copied the reactions of the family at the sight of a spider waving over our food.
Then, much to my delight, my little friend took off in his play. I was holding a fly and he had the spider when he hid the spider under a mound of Play-doh and started counting. I followed his lead of starting a game of hide and seek with our bugs! We took turns searching for each other’s bugs and he created two new spots for hiding–great flexible play. Then I got out my Play-doh oven as an option for a hiding place. After our bugs hid in it, he piled several bugs in and started to lift it up with sound effects. I asked what he was doing and he said, “It’s landing.” When I asked what is was (the oven), he said, “A plane.” Wow! That was an exciting step up in pretend play to assign a different use to an object than what is it intended for. He proceeded to fly his “plane” around the room on its way “to London” before it had to land so the bugs could go home.
Little steps like that make my day.
CNN reported a study published on Monday in the Journal of Pediatrics that found an increase in the number of children with autism and related disorders in the United States. The number is up to 1 percent of children from the age of 3 to 17.
The study is based on the results of the federal government’s 2007 national survey of children’s health, where parents were asked by telephone if a health care provider had ever told them their child had an autism spectrum disorder. In a follow-up question, parents were asked if their child was currently considered to have ASD. Nearly 40% of the respondents said no.
The question is whether the original diagnosis of ASD was accurate since the disorders are not considered curable. To that point though, as therapists we see children who receive massive hours of early intervention after a diagnosis of ASD, and years later they are “undiagnosed,” due to great improvement in their social and language skills.
The new statistics may be accurate and autism may be on the increase or maybe we are better diagnosticians. According to the CNN article,
“The researchers urged caution in interpreting the change, noting that an increase in diagnoses does not necessarily mean that more children have the disorder. It could simply reflect a heightened awareness of the disorder.”
In any case, heightened awareness is good if we can identify children with ASD early and get them the early intervention services they need to make maximum progress.
Halloween is a fun time of year for kids and an easy theme to introduce into therapy. Today I want to share a few books on that theme that are simple, yet fun and can be incorporated into a language or articulation lesson.
Last week I went to the home of my little friends on the autism spectrum. Books aren’t always his favorite activity and I try hard to find stories with simple, funny, stories linked to his experiences. First we popped popcorn in a pot with a glass lid. What fun to see the kernels pop and overflow, just like the story, Popcorn, by Frank Asch. We took pictures of the steps so we could order them later in re-telling our activity. Then we read the book and took advantage of all the opportunities to ask wh-questions relating to the pictures supporting the story, and describe the action, especially on the party page.
Sheep Trick or Treat by Nancy Shaw begins with “As the Halloween moon rises, sheep are fixing up disguises.” These well costumed sheep go trick or treating through the farm and encounter some wolves on the way home. Good thing they are dressed up to scare their enemies and arrive home safely to eat their treats! Shaw’s clever series of sheep stories in rhyme are great for pre-literacy skills as well as articulation practice with the /sh/ sound.
Aaaarrgghh! Spider! by Lydia Monks is one of my favorites for the season. This tale is about a lovable, persistent spider who wants to be adopted as the family pet. It is a good story to talk about feelings and associated facial expressions of surprise, fear, happiness and excitement.
Apples and Pumpkins by Anne Rockwell is another seasonal book that is a simple, concrete story about the experiences of going to the farm and picking apples and pumpkins, and returning home to carve the pumpkin and go trick or treating. This book could be used as a social story for children on the autism spectrum before a fall field trip, pumpkin carving or trick or treating.
If you work with children on the autism spectrum, please let me know what books have been interesting to your little clients. I would like to develop a list to share with other speech therapists and parents. You can comment below or e-mail me directly at sherry@playonwords.com. Thanks!
Like other professionals today, I am always on the alert for signs of autism in children that I see, so that if needed, I can help parents get the best help, fast and early for their child. I am amazed at the progress many children can make if they are diagnosed early. When I worked at the Early Childhood Center in Fairfield, I would start with children when they were 3 years old. When I looked back at reports of their status just a year earlier, at 2 years, I couldn’t believe it was the same child. They had had many hours of therapy, and it showed.
Recently, I was having a play session with a little boy, whom I was seeing for my “play on words” session, where I show parents how to talk, read and play with their typical youngsters, to enhance language. This little boy was 2 1/2 exhibiting some “red flags” for autism. At first nothing appeared to be off. He was playing nicely by himself with his little Fisher Price animals and talking in short sentences of a typical length for his age. This can be misleading because one might think that language is fine if they can talk in sentences. But, language is more than grammar. Pragmatic language, or social language is a key component in a child’s overall language age. A child at this age still typically plays next to another much of the time but also engages in play with peers and adults and has conversations back and forth, looking the other person in the eye. But when I came into hir play with a figure or piece of the action, he didn’t “let me in” by looking me in the eye, responding to my questions about his play scheme, or seem to acknowledge that I was there. HIs mom began describing situations that she had observed her son in recently that were cause for her concern.
They were at the beach and his peers were busily playing together while she observed her son off by himself, not seeming to be interested or aware of their play. He kept throwing stones in the water repeatedly, not changing his activity.
Often between 2 and 3, when children are expanding their language into little sentences and developing the use of language to manipulate their environment–request things, show their dislike for things, ask questions–it may become apparent that your child is not using his language flexibly as he should.
If you have concerns be sure to discuss specifics with your pediatrician and/or call your local Birth to Three Services to have an evaluation. Autism Speaks is an excellent organization and has helpful descriptions of the signs of autism on their website.
In a new study out in the July issue of “Autism,” researchers from the University of Washington reported that parents of children with autism experienced more stress from the behavioral challenges rather than the stress of daily care taking of their child when compared to mothers of children with developmental delays other than autism.
The study’s author, Annette Estes, a research assistant professor of psychology, was quoted in Forbes as saying, “Mothers of children with autism reported more parent-related stress and psychological distress.” “I think that parents of kids with autism are resilient in many ways and it’s not the hard work of daily living that causes the stress. The think what’s most difficult for parents are the problem behaviors.”
The study compared two groups of moms—one, parents of preschool children with autism and the other, parents of children with other developmental delays.
The fact that moms of children with autism experienced greater stress dealing with their child’s challenging behaviors such as irritability, agitation, crying, or hyperactivity, is useful information to us as therapists and parents in planning a child’s therapy program.
Perhaps as we are planning an early intervention program for a child we are working with on the autism spectrum, we should prioritize working on challenging behaviors, thus decreasing parental stress, allowing parents who are already doing an incredible job, to be even more available to help their child.
Since this research is current, several news sources wrote about it. To hear from other parents experiencing the same challenges or get an idea of who parents feel raising a child with autism, just read the comments after there was a blog on this topic in the New York Times.
How do you feel about this current research findings?
Since early identification of children with autism leads to early intervention and a more promising outcome, researchers and professionals are working to identify key behaviors that lead to a diagnosis. The following is a summary of “Early Signs of Autism” in Advance Magazine:
Speech Pathologist Elizabeth Crais, PhD, CCC-SLP and her colleagues at the University of North Carolina, Chapel Hill, are using retrospective video analysis to look at home videos of children identified with autism before their diagnosis—as early as 9, 12 and 18 months of age.
Some of the behaviors they are looking at are:
· Stereotypical and repetitive behaviors which may be due to a lesser ability to engage in their social world.
· Sensory seeking behaviors such as pushing against something with their body, seeking the sensory input
· Delayed gesture development. Since gestures precede and accompany the onset of verbal language, they should be present as a child begins to point, show or give an object to make his needs known. Much has been written recently about the importance of gestures in the development of language. According to an interview with Advance Magazine, Dr. Crais said, “gestures, or lack of them, in the 9 to 12 month range are highly predictive of later language skills at ages 3 and 4.”
· Reduced joint attention behaviors—behaviors used when a child wants to direct another’s attention to something. This might be when a child brings a toy to you and looks up at you for a response, or points to a balloon that she wants.
· Difficulty with functional and creative play. Since children with autism have difficulty picking up behaviors from peers, so they don’t learn how to use toys and take them to the next level of pretend and creativity.
As a professional working with children on the autism spectrum, I am thankful to the parents who are sharing their home videos and my colleagues who are analyzing them so we can identify children earlier and hopefully help them learn these skills earlier to be successful.
When I arrived at the home of one of the kids I work with who is on the Autism Spectrum, I saw a long tunnel he had made out of cardboard blocks that ran the length of the room. Mom said he is into tunnels these days. I admired his architectural structure and then gave some tips to expand his play. Kids who are on the autism spectrum can get “stuck” in their play on certain concepts or objects such “holes,” “tunnels,” “switches,” or a specific play person such as the “king” or the “alligator.” When this happens, parents and therapists have to be creative to keep the interest of the child but model flexible play that might include what he is so interested in, but expand on it and grow his language.
Mom had thoughtfully added cars to bring in some action. Best to include cars or vehicles that hold people for some interaction and conversation. I suggested she take a few more blocks and build a structure at the end of the tunnel for play such as a parking garage, or a restaurant or a house to go to after exiting the tunnel. The object is to take advantage of his interest in the tunnel but then expand the play with something related to it. Bring the cars through the tunnel and then have your people stop in for lunch.
Think of scenarios that will encourage story telling and creative play. Continue to model conversations and stories, pausing to let the child imitate or expand on what you are saying.
Today I arrived at the home of one of my students who is on the autism spectrum. We enjoy playing games, playing pretend and reading books for learning.
He took me right to a big cardboard box on the floor that was laid sideways with both ends open. He announced that it was a tunnel. I got out my Fisher Price little people and vehicles, let him chose a figure (Papa) while I took the Mama and we started our play and conversation. The goal was to have him engage in conversation using his Papa figure while I talked back with mine, moving him from what could be perseverative behavior or talking (in relation to the tunnel) to flexible language. Therefore I set up different play scenarios, one at a time, to encourage flexibility.
After a chat, he ran his car with Papa through the tunnel and I put out a slide for a playground. He turned Papa over on his tummy and started to count to 10 and we were playing hide and seek. I got so excited! When it was my turn to hunt for Papa, I modeled different places to look–”Is he under the slide?” “Is he behind the bike?” Then I added a prop or two for his turn to see if he would generalize and use them for hiding places too. I continued to model, pull back and let him respond, add a prop or two and expand the play.
As we continue to play, I see progress in his ability to follow my models for play and occasionally add a novel action. These are little successes as my friend learns to play pretend.
Every so often I need to brush up on my sign language. Even though I have taken courses in sign language, it is like any other language, you have to use it to stay fluent.
Recently I have started to use sign language with a child I work with on the Autism Spectrum. After being evaluated at Yale, they suggested I use sign language while reading books to him. So far I am not sure if it is a distraction or help to his following the story but I will keep you posted.
I wanted to share a website dedicated to teaching signs, through its video dictionary, that I found very helpful:
“Signing Savvy” has large,clear videos of signs and an easy search option. It’s comprehensive dictionary gives you several options to be more specific. For example when I searched for “go,” they gave two options for “go” as in “go away” or “go somewhere.” If you sign up and give them some basic information like your name and address, you are privy to more options like the sign description.
Let me know if any of you SLP’s are using sign language effectively with children on the autism spectrum, especially higher functioning kids. How is it going and how are you using signs? What other sites do you find helpful?
Blue Orange Games, known for their “hot games for a cool planet,” continue to invent clever games for kids that are friendly to our environment. Their latest member of the family, “ChickyBoom,” calls on fine motor skill and balance, requiring slow, precise movements to remove a chick, bale of hay or wagon wheel delicately placed along the chick’s perch. Take turns plucking pieces off the balance beam without letting it topple. After the perch is dumped, collect your pieces and call upon your math skills to count up the numbers on each one to see who has the highest number to declare victory.
This simple game of balance, math and strategy can be used effectively as a reinforcer for articulation and language therapy. I have written in a previous blog of the merits of good board games for teaching social language to children on the autism spectrum, and this is another such game that is simple enough with quick turns, but can be used to teach social skills as well as concepts such as high/low, same/different, heavy/ light and center.
I’ve used it to reinforce articulation learning by practicing sounds and taking a turn, or teach language skills like irregular past tense verbs as we “took” off a piece, “saw” where we put it, “put” it in our pile, “got” the block in the center, or declared that the chick “fell.”
Kids love the impish looking chicks and try to pluck them off first.
See my full review of “ChickyBoom.”
