Helping Children with Autism Become More Social : 76 Ways to Use Narrative Play

Foreword by Edward M. Hallowell, M.D. xvii Foreword by Margaret Bauman, M.D. xix Preface xxiii Acknowledgments xxix Caveat xxxiii Introduction xxxv Phase One: First Contact 1 Language 1 Play 2 Narrative 2 1 First Contact 3 Joining the Child Where He Is 3 Strategy 1: Experience What the Child Experiences 3 Strategy 2: Move into the Child's Play Space 4 Strategy 3: Listen to Each Detail of the Parents' Stories 6 Strategy 4: Interrupt the Child's Fixed Patterns of Play 7 Strategy 5: Help the Child to Feel the Presence of Others by Using the Environment 8 Encouraging Speech 10 Strategy 6: Show the Parents Details that Indicate a Child Wants to Play 10 Strategy 7: Set Up a Plan for Play Practice with the Family 11 Strategy 8: Move to the Child's Eye Level 13 Strategy 9: Teach Sound Combinations and Word Approximations for Speech Production through Play 14 Strategy 10: Encourage the Family to Use Their Native Language 18 Encouraging Flexibility 21 Strategy 11: Create Play Narrative Themes Related to the Child's Interest 21 Strategy 12: Identify the Methods that a Child Uses to Retreat from Others 23 Strategy 13: Change the Child's Narrative to Encourage Flexibility with Peers 24 Strategy 14: Be Direct and Teach the Child about the Other Child's Feelings 25 Chart: Progression of a Child with Autism from a Non-Social World to a More Social World through Narrative Play Therapy 28 Phase Two: Joint Attention Language 31 Play 32 Narrative 32 2. Joint Attention 35 Follow Child's Interest in Natural Things 35 Strategy 15: Help a Child Visualize a New Idea to Disrupt Old Patterns 35 Strategy 16: Join the Child and Listen to His Complaints 36 Strategy 17: Help the Child Visualize New Options 37 Strategy 18: Draw on the Child's Interests in Visualizing Objects and Places 37 Joining a Peer in Play 38 Strategy 19: Reduce the Child's Distractibility by Engaging Him in Sensory Breaks 38 Strategy 20: Name the Child's Feelings of Frustration and Anger 39 Strategy 21: Follow a Child's Lead toward Things of Interest in a Natural Setting 39 Strategy 22: Echo the Sounds and Point Out the Environment 40 Creating Narratives with a Peer 41 Strategy 23: Emphasize to the Child the Main Gestalt and Abstract Concepts of Natural Events Instead of Focusing on All the Tiny Details 41 Strategy 24: Take the Child to an Event More than Once to Teach Abstract Concepts 42 Strategy 25: Facilitate Language by Prompting One Peer First and Then Supporting the Other 44 Strategy 26: Create a Reason for the Characters in the Two Play Sets to Be Together 45 Strategy 27: Develop a Narrative with an Orientation, a Sequence of Actions, and an Ending 45 Planning and Solving Problems 46 Strategy 28: Help Both Children Plan a Play Sequence Together 46 Strategy 29: Create Repetitive Problems to Solve with Options for Solutions 48 Strategy 30: Describe and Model a High Point in Actions and an Ending in the Child's Story Theme 48 Phase Three: Child-Initiated Reciprocity 51 Language 51 Play 53 Narrative 54 3. Child-Initiated Reciprocity 57 Bringing the Child Together with a Peer 57 Strategy 31: Connect with the Child's Peer and Engage Both Children in the Ideas of the Play 57 Strategy 32: Narrate in Detail the Child's and the Peer's Actions within the Natural Play Interaction in Order to Reinforce the Child's Intentional Play 58 Strategy 33: Engage a Peer to Motivate the Child to Play, and to Move the Child Past His Repetitive Actions and Fixed Mental Images 60 Strategy 34: Model Symbolic Play with Objects that Have Meaningful Relationships in the Child's Life and that Relate to the Ideas in the Child's Play 62 Strategy 35: Ask the Peer Relevant Questions Directed at Finding Out the Next Sequence in the Story and the Object's Destination 63 Building Trust by Listening 63 Strategy 36: Use Gesture and Body Language with Meaningful Language, Pointing Out What the Peer Is Doing, and Making Suggestions to the Child for Actions that Will Connect to the Peer's Actions in Play 64 Strategy 37: Once a Child Consistently Looks at a Peer in a Quiet Office Setting, Follows a Peer's Point toward an Object, and Watches the Actions of a Peer, Take the Child to an Outside Location to Work on Joint Attention in Play 65 Strategy 38: Coach the Child's Parents, Teacher, and Aides to Run with the Child, to Move in His Rhythm, and to Point Out Actions in the Environment 66 Strategy 39: While Watching an Artistic Event or Using Art Materials, join the Child in What He Is Experiencing by Describing the Feeling, Sounds, and Images of the Natural Situation: Encourage the Peers to Participate in the Conversation as Well 68 Strategy 40: Use Child-Directed Conversation that Builds Trust by Remaining Calm and Attentive, Listening to the Emotional State of the Child, and Suggesting Language to Validate the Child's Feelings 72 Strategy 41: Listen, Wait, and Be Available to Respond in a Calm, Neutral Voice When a Child Expresses Anger and Disappointment, Offering Concrete Solutions Not Only to Validate the Child's Feeling, But Also to Shift Her Focus on What to Do Next 74 Strategy 42: Suggest Some Concrete Motor Activity that Not Only Encourages Eye Contact and Turn-Taking, But Also Involves a Simple Skill that the Child Can Perform with Ease 75 Strategy 43: When a Child Feels Angry at Herself, Suggest Activities that Can Be Accomplished with Little Effort, Stay Close to the Child, and Remain Silent at Times to Allow the Child to Express Her Feelings 76 Strategy 44: Introduce Simple, Concrete Games that Require Reciprocity and Provide Opportunity for Language and Conversation in Close Proximity 77 Strategy 45: When a Child Cries, Stay Nearby and Be Patient, Sensitive, Calm, and Attentive 78 Narrating Actions During Play 79 Strategy 46: Select High-Interest Activities that Address Not Only Learning Difficulties Such as Word Retrieval Problems and Memory Deficit but Also the Child's Sensory Needs 79 Strategy 47: Listen to the Child's Feelings in an Interaction with Others, Noting Ambiguous Terms or Figurative Language that May Be Linguistically Confusing to the Child 81 Strategy 48: Shift the Focus in Therapy from Asking for Direct Responses from the Child to "Narrating" the Child's, Peer's, and Objects' Actions and Feelings in Order to Motivate the Child to Express Spontaneous Ideas and to Notice What Is Happening in a Shared Event 83 Strategy 49: Observe the Child in Social Interactions and Intervene Only When Needed by Suggesting Language Scripts that Include Supportive Comments to the Child while He Is Involved with Peers 85 Bringing Language to Sports Activities 88 Strategy 50: Teach Language Skills Idioms, Figurative Language, Word Retrieval, Retelling, and Sequencing through Sports Activities on the Playground or at Parks with Visuals Called "Floor Maps" to Support the Child's Understanding of Rules As Well As Abstract Reasoning 89 Strategy 51: Model the Relationship between Tone of Voice and the Meaning of the Words in an Interaction for the Child with Autism so that He Can Experience How His Tone of Voice Affects the Meaning of Language; First, Use Play Figures Inside in a Quiet Setting, and then Role Play Outside with a Peer on a Playground 92 Strategy 52: Model the Relationship between the Loudness of a Voice and the Distance between the Speaker and the Listener for the Child so that He Can Experience How Intensity Affects What a Listener Can Hear in Various Situations 93 Strategy 53: Minimize the Number of Objects in a Play Set with Two Peers and Organize Play Activities with High Interest, Simple Themes, and Concrete Action 95 Strategy 54: Use Concrete Activities such as a "Gertie" Ball to Teach Language Reciprocity and to Acknowledge the Child's Need for Physical Activity 97 Strategy 55: Assist the Child and a Peer to Negotiate over Tangible Objects in Play and Share Play Sets 98 Strategy 56: With the Child and a Peer, Create and Practice Social Scripts, Called "Options," Which Are Language-Based and Solutions to Social Problems that Occur in the Child's Home or at School 98 Phase Four: Social Engagement 105 Language, Play, and Narrative 105 4. Social Engagement 107 Helping the Child Fit In 107 Strategy 57: Validate and Acknowledge a Child's Feelings by Listening Attentively When She is Disappointed by Inappropriate Comments from Others or Feels Isolated from Peers 108 Strategy 58: Join the Child in Reflecting Back on Her Initial Therapy Sessions to Understand the Progress She Has Made 109 Strategy 59: Recognize the Child's Awareness of Not Fitting in with a Peer Group; Talk Alone with Her about New Conversation Strategies As Well As Subtle Gestures She Can Use to Signal the Therapist that She Needs Help 110 Strategy 60: Understand the Difficulties and Characteristics of the Language Disabilities that Accompany Autism and Impair a Child's Social Interactions, Writing, and Perceptual Motor Skills 112 Limiting a Child's Monologues and Encouraging Listening 113 Strategy 61: Join the Child at Lunchtime or Recess Time to Help Her Practice Social Skills with Peers by Introducing Simple, Concrete Conversation Topics 114 Strategy 62: Stay Close with the Child on the Playground; as She interacts with Her Classmates, Function as Both a "Peer" and a Conversation "Coach" and then Fade Back to Observe 114 Strategy 63: Model Language Facilitation for Specialists and Teachers by Joining the Child, Making Comments, and Using Gestures as Needed in an Outside Situation 115 Strategy 64: Practice with the Child with Autism and One Peer the Technique of Using an "A B C Conversation" to Limit Monologues and Help Her to Respond with Relevant Conversation 117 Creating Visuals to Redirect Repetitive Thoughts 120 Strategy 65: Through Role-Play and Visuals, Practice Listening for "Key Words" with the Child and One Peer 121 Strategy 66: Create Small Books with Photographs and/or the Child's Drawings; Add Dictated Writings (Child Tells the Therapist What She Needs to Write Underneath the Photo/Drawing) to Help the Child Redirect and Eliminate Invading Thoughts about Unrelated Subjects 123 Strategy 67: Develop Visual Materials to Preteach a Child about the Sequence of an Event or Field Trip; Use These Materials Later to Develop a Narrative about the Trip 127 Strategy 68: Help the Child Watch Others Interact on the Playground by Pointing Out the Peers' Behaviors in the Interactions; Later Create Drawings with the Child to Talk about How to Read Subtle Language Cues Such as Facial Expression, Gestures, and Body Language 128 Strategy 69: Teach the Child about a Peer's Perspective in an Angry Interaction by Creating a Visual List of the Peer's Feelings As Well As the Child's Feelings 130 Strategy 70: Teach the Child with Autism to Interpret a Peer's Discomfort and Pain by Comparing the Painful or Sensitive Situation to the Child's Feeling in a Similar Incident 131 Developing Strategies for Negotiation and Reasoning 134 Creating Strategies for Beginnings and Endings 134 Strategy 71: Help a Child with Autism Illustrate and Outline Steps that Will Logically Help Him Draw Inferences from Abstract Texts As Well As Ambiguous Words in Classroom Projects and Concepts Related to His Curriculum 134 Strategy 72: During a Conflict or a Negotiation, Teach the Child with Autism to Identify Shared Interests with Others through Six Stages of Negotiation by Modeling and Questioning Both Children in an Interactive Play Situation 136 Strategy 73: Introduce Creative and High-Interest Activities in Outside Settings that Are Linked to the Child's Natural Experiences with Family and Friends 143 Strategy 74: Create Natural Situations for Play-Dates/Free Time with Peers and Provide an "Overall" Structure that Is Predictable 144 Strategy 75: Support the Sibling As Much As Possible in Natural Situations 159 Strategy 76: Create Natural Situations for Ending Therapy with Children and Help Them to Look Forward to New Relationships 166 Appendix 1: Facilitating Language in Play Dates for Younger Children: Suggestions for Parents, Specialists, and Teachers 173 Appendix 2: A Playground Program for Peers at Recess in School: Suggestions for Teachers and Specialists 177 Appendix 3: Working with Siblings: Suggestions for Parents, Specialists, and Teachers 179 Appendix 4: Social Language Scripts for Unstructured Time in Situations at Playgrounds/Parks: Suggestions for Teachers, Specialists, and Parents 181 Notes 185 References 207 Index 217