Advice to Parents of Children with Autism – Tips to Help Your Child Communicate.

At the outset, I want to share a Poem by Roland Kilpatrick – Father to daughter, Linnea, who is on the spectrum:

Autisms Hope

Too many noises

Too many sights

Too many voices

It’s just too bright

So I cover my ears

‘Cause I still need to see

But all of this input

It overwhelms me

Don’t know where to look

Don’t know how to play

Please excuse my long pauses

I’ve plenty to say

But a lot’s trapped inside

It won’t come out on cue

‘Cause I really need you

Right now I’m still little

But I won’t always be

Maybe then I’ll help others

Just like you help me.

A child who has been diagnosed with Autism Spectrum Disorder initially seems to be a mystery. He/she is often referred to as “being in their own world” or “locked in a cocoon”. A cocoon with a potential to keep the individual inside for as long, unless someone from outside tries to set their foot in. This process of trying to enter the child’s world can be extremely challenging and overwhelming for people who interact with them.

Autism spectrum disorder is a developmental disorder that affects communication and behaviour. It is estimated to be occurring in 1 in every 68 children but yet the diagnosis is not totally understood by a large section of the medical world itself.

We live in a society, which finds it difficult to accommodate non, neuro-typical individuals and simply refer to them as special needs children or adults, without understanding the ‘special needs’ at all. Fortunately, parents, currently are well informed and are making special efforts in understanding and making others understand the condition their children are in and why.

There are many concerns in parents of kids diagnosed with ‘ASD’.
The prime concern being – how they can promote language development in these kids. Parents or caregivers are people who have immediate contact with these kids and hence try to get the whole picture, as the children might not have an effective way to convey their wants or thoughts. Failure to convey their needs or emotions in turn creates a risk of developing tantrums, aggression or causing self-injurious behaviours as a replacement.
These behaviours are often misunderstood by us and we miss to perceive the fact that these might be a result of several hidden underlying conditions. And hence, speech and language skills or non-verbal communication becomes one of the primary goals for the child achieve.

Various platforms are dispensing a lot of information, reaching out to Parents dealing with kids in the spectrum, explaining the what’s, why’s and how’s of ‘ASD’.

The sole purpose of this article is to focus on sharing strategies for promoting communication in children with Autism. However, here we need to understand that each child is unique and especially a child with ASD is far more incomparable in his/her own ways. Hence, there is no ‘one size fits all’ approach when it comes to dealing with each one of them. A strategy that works well with a child with certain challenges may not fit another child with the same challenges. Moreover, a person with autism can learn to communicate, but it may not be always through spoken language. There are several individuals in the spectrum who are non-verbal and are leading fulfilling lives with help of assistive technology aids or devices.

Here are few tips to initiate communication in children with ASD.

1. Observe the individual differences: Individual differences are traits that distinguish one person from another and hence design a unique personality trait for each one.

Understand your child with respect to his self-regulation (energy state, emotions, thoughts and behaviours), his motor planning (his skill to carry out any motor act), receptive language (his understanding of words, verbal utterances or gestures), expressive language (how he/she expresses his needs or thoughts), visual spatial processing (his awareness of his surrounding and himself) and praxis (how he/she deals with a task, based on his/her past experiences).

Understanding a child’s exclusive abilities, behavioural and emotional state will pave a way to the first stepping stone towards entering his/her world. When the child knows that someone is interested and accepts them the way they are, they will definitely attempt to take a step towards that person too.

2. Take his lead: Although we know that certain behaviours a kid with ASD shows, might not be well appreciated by his surroundings, however as mentioned earlier we may not be completely aware why he/she is exhibiting the same. Hence, instead of pushing them to change their path, follow his road and see what he shows us ahead. That is to say, if a child is singing a song, we may sing along, if child is showing a repetitive play with a toy, we may do the same and then we wait and observe what the child gives us. It may start with initially an eye contact and then enjoying your presence. Remember to just be. This is where first step of interaction begins.

3. Initiate a change: Initially the play might not mean anything. He is playing with sand – you play along, he is climbing up a ladder and then you are there to help him down, he stacking his building blocks – you hand him the blocks. Once this companionship is established, instigate a change, may be a small change, as small as dropping a block while he was building it and then observe if he gives you eye contact and waits for you to pick it up and further will he/she wait longer when you suggest that you seem to be struggling to pick it up.

4. Modify and invite: This step needs to be taken up gradually as any kind of change is not happily welcomed by individuals with ‘ASD’ mostly. Using the same example I mentioned in the previous point, where the child is stacking blocks, you may stop helping him/her and then observe if he/she asks you to continue helping (verbally or through gestures). Another modification which you may introduce is to put the blocks in a box with a lid and check if he may need help to get the blocks out. Observe if he extends his/her hands, pats on your hand or even tries verbalising.

5. Encourage use of non-verbal communication: Building eye contact and learning gestures develops foundation for language. Encourage the child to use certain gestures in routine for his/her specific needs. You may teach them through modelling. We are talking about encouraging non-verbal communication here, this doesn’t mean that we refrain ourselves from using speech with him. Talk to him about what he needs and give him words such as “Oh! You are pointing at the cookie jar, I think you need a cookie” and help him to point or extend his hands to get the cookie. Exaggerating your speech and gestures will also help him/her
   to notice what he/she is expected to do, but use of gestures are easy for the child to use.

6. Make your environment communication friendly: Just as children use communication primarily to satisfy their basic needs, so we may observe children with ‘ASD’ too using communication primarily for their basic needs. If he/she is a non-verbal child, initially you may understand the needs through his/her cry patterns, behavioural changes or even based on their daily routine. However, once the child reaches a level of understanding that certain gestures or utterances suffice his needs then parents are to design their environment in such a fashion which motivates the child to ask you for your help to meet his/her requirement. This is referred to as making your environment communication friendly.

7. Model: Modelling is kind of a vicarious learning in which direct instruction might not occur. It also aids in developing observational learning or social learning. Modelling is a required behaviour which may include gesture or utterances. Parents need to Identify contexts which elicit frequent attempts of communication and then encourage the child by modelling him/her to use gestures or utterances or even alternative aids to communicate his/her needs.

8. Give words but don’t bombard: Start with demonstrating use of specific words tailored to a specific ‘communication eliciting environment’ and then encourage him/her to use the same at these contexts. Eg. Use of word ‘shoes’ to go out or, use of word ‘open’ to open a cookie jar etc.
   
   Children with ASD are different than children with delayed developmental milestones. Hence, auditory bombardment strategy usually helps the latter population more than in children with ASD. While dealing with children in the spectrum, we often come across situations when they feel overwhelmed or have episodes of meltdowns due to overloaded auditory stimulus. Most children with ASD have hypo or hyper reactions to various environmental stimuli which we may or may not be aware of and bombarding them with instructions might just overburden them. Hence, choose your utterances carefully and largely focus on commenting rather than commanding or questioning.

9. Pretend: Let the hidden small actors in us bloom and let us use the requisite skills to build communication in our children. Yes, pretending can be named as the ace of all strategies and may help you win the game. However, this should be used strategically to prevent getting the child’s participation. Eg. The child is pulling you (he wants to step out), you give him a look, pretending not to understand what he wants and continue your work, he continues pulling and you may comment “you want me to move?, here you go” and I move to another corner. Again he pulls and I say “I guess you want to play the pull and push game with me, let’s do it” and continue pretending till you can elicit a self-intended gesture (such gesturing to call you or pointing towards door or his shoes), utterance (such as ‘come’, ‘out’, ‘shoe’ etc.) or option selection in his/her assistive device. This may help the child understand the purpose of gestural or verbal mode of communication.

10. Use of assistive devices: I wish to highlight in bold that AAC (Alternative Augmentative Communication) devices ARE NOT REPLACEMENT FOR SPEECH and in no capacity discourage the development of speech. These aids will only enhance the opportunities of communication. These devices bring the child to a comfort level that ensures availability of an alternate communication medium to convey their needs and thoughts when their own vocabulary seems to be limited. It is their right and our duty to have these alternate aids made available to them.

Parenting is a journey and we all have our own amazing travel experiences as parents. This journey is filled with happiness, joy, thrill, adventure and many challenges. We will run into each of these at some point. However, the fact we need to remember is that we all have different destinations to reach with our child. And even if we share a destination with someone we will have to take a different path to get there. Hence, let’s move ahead at the child’s pace by giving them adequate space to absorb information from their environment. Concurrently, it is vital for parents to take care of their own well-being by taking time to relax, have fun, exercise and socialize.