The KEYHOLE Early Intervention Programme in Autism Spectrum Disorder. Booklet 4. Interaction. Facebook: /AutismNI

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1 The KEYHOLE Early Intervention Programme in Autism Spectrum Disorder Booklet 4 Interaction Facebook: /AutismNI

2 THE KEYHOLE EARLY INTERVENTION PROGRAMME IN AUTISM SPECTRUM DISORDER Social Interaction Social interaction is something that we take for granted. We believe that it should develop effortlessly. Social interaction involves skills like good eye contact, being able to share a book, a game or even a joke with one or more people. It is the ability to know how to speak or respond when someone speaks to you and also the ability to keep the conversation going and to know when to be quiet and listen. Young children with Autism often find social interaction very difficult for a number of reasons: - They may not understand what is being said or what is going on around them - They may not know how to respond to you or others - They may find the sensory experience of someone looking and speaking at them overwhelming Often the child with Autism withdraws from the busy, over-stimulating and ever demanding social world. Some children with Autism rarely interact with others, even family members, except during rough and tumble play when they may join in the interaction by looking and sometimes smiling. They may get upset or just walk away if you try to join in on their solitary activities. Some children with Autism will spend most of their day engaged in solitary activities. Often their interaction will be needs-led when they will initiate by approaching to get an adult to get something they want. They may want to play in social games such as chase, swings, tickles and bubble play but this may be on their terms, and they stop when they want to. They are unlikely to understand the social rules of taking turns or joining with others. As your child learns to understand and use more language, he may begin to interact with more people. He may become more interested in the children in his playgroup or nursery school. He may interact with people for more than just to get what he wants. He may now point things out and say the name of things he sees. He may be able to greet people he knows. However, conversations may be short and often unusual. In this booklet you will learn about: - Rules for Easy Interaction Taking Interaction Further Encouraging Interaction 1

3 Booklet 4 - Interaction Rules for Easy Interaction To help your child learn to interact more often and for longer with you, you must first help him to pay attention to you. - Get down to his level and be face to face with him - Imitate the sounds and actions he makes - Keep your language short - Use an animated and lively tone of voice - Bring objects or toys closer to your face Always include his interests. If you watch your child play you will see what interests him the most about the toys and objects around him and he will show you how he likes to play with these things. Try to join in with him by: - - Following his lead - Doing what he does - Handing him more of the same objects to play with, one at a time - Hiding little toys or objects where he can find them, in your hand, up your sleeve etc. Make a list of what motivates your child to interact with you. Usually rough and tumble play, sensory games and fun repetitive games are the most motivating to the young child with Autism. Once he knows how to ask to play these games you will know they are games that really interest him. He will be motivated to interact with you to ask for more. 2

4 THE KEYHOLE EARLY INTERVENTION PROGRAMME IN AUTISM SPECTRUM DISORDER Rough and Tumble Games to try You need to make sure that your child is aware that something they like is about to happen so, get their attention. Use repetitive language and a tone of voice that will let your child know something exciting is about to happen. Try a swinging game. Count him in 1 Pause 2 Pause 3 Then SWING 3

5 Booklet 4 - Interaction It doesn t matter what you do, here are some examples of other games you could try. - Row Row Row Your Boat - Chases - Tickles - Horsie Horsie - Up and Down Swing It must be a happy experience if he wants you to repeat it. Be led by your child, he will soon let you know if he does not like the game! Remember to allow your child time to respond back to you before repeating the activity. Sensory Games to try - Bubbles - Water Play - Cause and Effect toys with flashing lights - Musical Toys Fun Repetitive Games to try - Peek-a-boo - Balloons - Round and Round the Garden It will be much easier to encourage your child to interact with you when you remember to aim for a successful interaction. The more often you engage your child in fun interactions the more he is learning about imitation taking turns using eye contact asking for more! Sometimes your child may reject your attempts to join in with him. If he is still telling you no after a few attempts then that s OK, we all need quiet time too. 4

6 THE KEYHOLE EARLY INTERVENTION PROGRAMME IN AUTISM SPECTRUM DISORDER Take Interaction Further Each time your child engages in interaction with you, he is learning. Make the most of these opportunities when they happen, to help him develop his interaction skills further. Help him make better eye contact For children at all stages of development, eye contact may not be a strength. Help him to make better eye contact by changing the way you interact with him. Always aim to be in a face to face position so your child can look at your face without any effort. This will encourage better eye contact. Bring the object he is interested in closer to your face so that you draw his eyes towards your face. Wait a few seconds longer before you continue a fun social game. In this way your child may make fleeting eye contact with you as he tries to work out what s next. Avoid using very direct statements such as look at me unless saying this is really necessary to get your child s full attention. Eye contact is a skill, which we have acquired without ever being aware of it. We should aim to teach our children the rules of interaction in the most natural way. Example:- Holly at the beginning of her KEYHOLE Therapy, never intentionally made eye contact. However, the first day bubbles were brought out Holly was fascinated and was really motivated to see more and more bubbles being blown. The first few times her mum blew bubbles, Holly would stare intently at the container and then at the bubbles as they floated about her. After a few turns her mum started to wait a little bit longer before blowing more bubbles and Holly began to look for just a second to make fleeting eye contact with her mum. Holly s mum was delighted and very quickly blew more bubbles to encourage Holly. Holly played this game and other repetitive social games with her Mum and Dad and gradually she used eye contact to request more turns and to share the fun of the game with the adults who played with her. 5

7 Booklet 4 - Interaction Help Him Take Turns Children with Autism need to learn to respond to your interactions and also how to respond back. We expect children to take turns by looking at you, smiling, making a sound or body movement. Help your child take turns in a fun interaction by doing what Holly s mum did. Use a repetitive game where your child will have lots of opportunities to learn how to take a turn. By waiting a little bit longer each time in between the turns of a game, you will give your child the opportunity to ask for more in his own way. This may be by him pushing your hand, handing you a picture or an object or saying a word, but you can take this a step further. Imitating what he says or does and then looking expectantly, wait for him to take another turn. This may be a repetition of what he has said or done before but that is fine, he s still taking his turn. Using nursery rhymes and songs at this stage will also help your child learn to imitate and take turns with you. Teach your child the songs and actions. Sing the songs with your child on your knee. At the end of each line in the song, stop and wait, see if your child will take his turn. As your child becomes more familiar with the words he may make a sound or word to take his turn. As long as you are having fun your child should find it easy to continue with the interactive game. You will help your child take a few more turns each time by keeping this simple but fun. All children, even if they have speech, will benefit from these repetitive games. Some children with speech do not necessarily understand the social rules of communication. These games will help. 6

8 THE KEYHOLE EARLY INTERVENTION PROGRAMME IN AUTISM SPECTRUM DISORDER Looking at Books With Your Child It is important to encourage your child to become familiar with books. This will encourage his attention skills, his ability to take turns and is another way to encourage interaction Encouraging Interaction with other children Your child will learn to interact with adults first and then with other children when he is ready. You can encourage his interest in this by providing opportunities for him to be around other children. Taking him along to a parent and toddlers group or a small playground is a good place to start, or inviting friends to your house. Start with short periods of time. To begin with all you should aim for with your child is: To tolerate being around other children To watch other children To play beside other children if he wants. It is not a good idea to force this until your child is ready Some children may then move to begin to interact briefly with other children. They may play alongside other children using the same toys. They may even imitate the sounds and actions of the others. They may, have some difficulty sharing so be prepared for this. Remember almost all children struggle with this concept in the early years. Your aim for your child should be to help him to learn how to take turns with other children. 7

9 Booklet 4 - Interaction Understanding Turn Taking Waiting and taking turns is very difficult for young children with Autism. They cannot make sense of it. It may be useful for your child if you introduce an object or picture which they always use when then need to wait. Learning to wait is the first step in being able to take your turn. You may need to help your child see when it will be his turn and teach him about turn taking. Both people in the game need to have something they can see which tells them to wait because it is the other person s turn. This may be objects such as counters. For example, when it is my turn I take a counter off a card and place it in a box. Then I have my turn at the bubbles. When it is your turn you take a counter off the card and put it in the box and have your turn. The child with Autism needs to learn this routine. You may need to help your child see when it will be his turn and teach him about turn taking. Being able to see this, will help them understand what turn taking is all about. Use a turn taking card Once your child can cope with taking turns with you he can then try taking turns with a child of his age with you only needing to supervise at a distance. 8

10 THE KEYHOLE EARLY INTERVENTION PROGRAMME IN AUTISM SPECTRUM DISORDER Top Tips For Better Interaction Engage your child s attention Include activities he finds motivating Use simple language Imitate what he says or does Make comments Keep questions simple Allow time for a response Let him take his turn in his own way Look expectant with exaggerated facial expression to signal it s his turn Use nursery rhymes and action songs to encourage interaction Use books when your child is ready to encourage more interaction Encourage your child to be with other children Use a turn taking card or object to help your child learn to share and take turns 9

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12 Dedication The KEYHOLE Booklets are dedicated to the children and their families who participated in the KEYHOLE Early Intervention Project. Their openness, cooperation and commitment are at the core of the booklets. They gave heart to this work. Their opinion, experiences and insights gave the booklets their direction. They gave hope. Funded By: Booklets written by Heather Crawford MBE (Speech & Language Therapist Manager) and Kate Doherty (Senior Teacher Autism Spectrum Disorder)