I began working with children on the autism spectrum during my first clinical practicum as a graduate student clinician. Now, three years later, I still learn something new each time I work with these children. Every individual child is so special and unique; they are each a puzzle with many layers underneath. I’ve compiled a list of the most important lessons I have learned so far, and I’m so excited to learn more everyday I continue to work with these wonderful kids.
When I say completely unique I mean it. From likes, dislikes, personalities, sensory and motor needs, and diet they are all just so unique. What might work well with one child is not always going to work for another or even with the same child on a different day, so for anyone working with this population, I suggest to have a wide array of tools in your bag of tricks. Be ready to change up your lesson or treatment session in a moment’s notice. This flexibility will serve you well.
I was taught that people on the Autism spectrum have difficulty showing and understanding emotions. While this is typically true, I did not realize that some people with ASD’s show their emotions readily and willingly. For example, they can be very blunt or look bored when they feel bored. For these individuals, they might understand emotions and recognize them on others perfectly but they may not understand how their emotions can impact others. For example, they may need help understanding why it is not ok to yawn in someone’s face if they are bored. Michelle Garcia Winner has materials on “feigning interest” which is a skill many need support to learn. In these cases, the lesson is about hiding your emotions in order to be more socially appropriate rather than highlighting them.
I currently work in a public high school (for part of my week) and often hear other therapists say “I’m so thrilled with how so-and-so is doing! He did not look like this when he was younger” or “They look like a different person!” This makes me realize that you never can be certain with the prognosis for these children. They can pleasantly surprise you with their progress.
I say this for parents, teachers, and therapists. A sensory diet was a new term for me as a graduate student clinician. Every individual has their own specific sensory and motor needs. It is very important to work with the entire team (PT, OT, SLP, Behavior Analysts, teachers, and parents) to identify the child’s needs. Some children may require two minutes with a squishy ball to calm down and regulate. For another child, two minutes may be far too long. This information can improve behaviors and help children better access learning.
Visual supports are powerful tools in the hands of special educators/therapists/parents. The difference I see in behaviors when using a visual schedule and when not using one is enormous. Visual tools such as first-then boards, schedules, checklists, and timers have such power for these children. A visual schedule can mean the difference between a child being taken throughout their day by adults or actively navigating their day for themselves.
Some of these children are developmentally young, so it makes sense that they need longer periods of time to understand concepts and to communicate. Typically developing children see and hear things for at least one-two years until they understand and can say them. It might take our kiddos years to be able to ask for a break or tell you they need the bathroom so don’t give up if you aren’t getting the desired results in a couple of months. Definitely modify and change up the presentation if progress is stagnant, but remember that it might take a significant amount of time.
I know the iPad is all the rage right now and while it can be a great educational tool there are some things to watch out for. One being that the iPad can’t be used in lieu of actual therapy. Apps can’t replace educators and therapists but they can be useful for materials and motivators.
Something look out for is an increase in scripting. Scripting is when a child repeats phrases from their favorite shows, videos, or songs over and over. I have seen occasions where receiving an iPad triggered a significant increase in scripting. This is distracting for the child and can hinder their access to learning or engaging in their environment.
The iPad can provide easy access to their favorite videos, songs, or apps, so be watchful and don’t allow the child to have unlimited time to watch their favorite show or video clip. Visual tools can be helpful here. A picture of an iPad and three stars or check marks can be used to let the child know that they can watch the clip for three more minutes or three times during the day.
We’ve all been there. Your student or child is mentally and physically spent and more effort is going into salvaging the activity than running it. It’s not always easy but it’s better to throw in the towel. I’m not saying just stop and let the student do whatever they want, but rather think of how you can end with structure and finalize the activity. Maybe use a countdown visual or timer to let the student know that they need to complete a task (it can be as simple as help clean up or put this away) and they will either get a break or receive the item they want.
There is no reason why work time can’t be fun. Not only to motivate and get children engaged in learning, but because they do work so hard. Many children I work with have multiple therapy sessions each day, class work, and outside therapy or activities after school. That is one long day! I strive to make my session interesting and fun while still challenging the students and expecting them to work.
What do you guys think? Anything surprise you about working with or raising an Autistic child? Leave your ideas in the comments! Be sure to sign up for our mailing list here to stay updated with our latest therapy tips, app announcements, and blog posts. Don’t forget to follow us on Twitter, Pinterest, and like us on Facebook.