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Yes, I admit it: I am a huge meanie who spends lots of time forcing small people to communicate. Yup, guilty.
When I am starting a new early intervention case, something I like to do is give my staff an “Early Learner Protocol”. Over the years I realized there are so many important skills to teach and not enough hours in the day, so I wanted my staff to have a tangible understanding of the focus of intervention for the little ones. To summarize: reducing problem behavior and increasing imitation skills, play/socialization skills, and LANGUAGE are usually the main things we are intensively targeting with young clients.
I try to get staff and parents to understand that everything involved with working with early learners is all about Pushing. If you can grasp the concept of pushing, then you will do just fine as an ABA therapist for any young child.
Pushing could look like, “He manded for a sip of juice, lets try having him mand for a bite of cookie”, “She labeled 2 toys in the bath last night, lets push for 3 tonight”, “He waited 10 seconds before I opened up the pretzels, now I’ll push for 12 seconds”. See, push.
I remember the mother of the first client I ever worked with telling me that her son was perfectly content to allow me to do everything for him, if that is what I chose to do. I didn’t really believe her at the time, and thought to myself she was just too hard on him (she was just being a meanie). So what if he needed help putting his shoes on…every day. My job was to help him, right? Then there was the day I observed him with another ABA therapist and it went a bit like this:
Therapist- “Put your shoes on”
Child- (promptly put his shoes on)
Imagine my shock :-) After the shock faded then I just felt like a chump. I had been putting this child’s shoes on for weeks, and the entire time he was fully capable of doing it himself. Lesson learned!
To parents and new ABA staff, I know it feels like helping but it can actually be harmful if you neglect to push the child to learn new skills, dress themselves, talk, display manners, etc. It’s kind of like saying “Since this child has special needs, I’ll just lower my expectations”. You would never say that out of your mouth, right? Well then don’t say it with your actions.
When it comes to teaching/expanding on language, motivation is KEY. What motivates you and I to communicate with others may not at all be motivating for your child/client with Autism. Or let me put it like this, have you ever considered why the child should communicate? What do they get out of it? If they don’t communicate, is anything different? Does communicating make their life better somehow?
Here are some practical ways you can start to push more, to increase language, build independence, and teach skills. Many of these are things I do on a weekly basis across my clients.
- When the child wants something (a toy, to watch a TV show, etc.) place a demand on getting it. Connect some form of communication to accessing the most preferred items, instead of giving them away for free.
- Embed language trials into daily activities, such as eating breakfast, walking to the park, or getting dressed. As your child is getting dressed say , “Pick up the SHIRT/Give me your SHOES/Pull your shorts UP”. Repetition and prompting are how you get the child to respond to your language. I embed language into almost everything I do with an early learner.
- Mimic and imitate the child’s sounds. This is also a great way to get spontaneous eye contact (my clients usually stare at me like I’m crazy), and this can become a fun social interaction. Sit or lay down near the child and make the same sounds they are making, including pitch, intonations, etc.
- Look and sound like someone worth talking to. With my early learners, I smile big and keep animation in my facial expressions. Everything is a bit exaggerated. Talk a bit louder than usual, and lay the praise on super thick. If interacting with you is fun and exciting, the child will approach you more which just gives you more opportunities to push.
- Don’t give up too fast on manding trials. This is a mistake I see all the time. The child wants something, so you withhold it and try to get a mand. Then the child cries, walks off, or stares blankly at you. This is totally normal, and doesn’t mean the child is confused. It could mean they don’t want to mand, or they just don’t want the item anymore. What it definitely should not mean, is you give up on the manding trial and just give them the item. If problem behaviors occur, just silently withhold the item. If the child leaves or walks off, let them. If they really want the item they will come back. When they do, just restart the manding trial.
- Sing songs to the child, or with the child. Music can work wonders for teaching or expanding on language. I’ve had many clients who would sing or hum far-r-r before they ever said words. Don’t just play music though, remember this is about pushing. Sit down with the child and sing songs that have movements, such as Itsy Bitsy Spider. Remember to be fun and animated, with lots of praise. Or, dance/hop around while singing together and then stop and look intently at the child. They might keep singing (we call this “fill ins”), or tug/pull at you as a way to request more singing. I also like to do songs that include suspense or surprise, such as “….we all fall (pause and freeze dramatically) DOWN! (lightly pull child to the floor and tickle them)”. After you do this a few times, the child may start requesting more of this game such as tugging or pulling at you to do it again. That is when you add a demand, such as the child saying or signing “more”.
- Receptive language is language too! “Receptive” just means an action is required and not a vocal response. I rarely see parents think to work on receptive language with their children, but it’s a very important part of language development. Get some flashcards or pictures and have the child match them as you label the item (“Tree”), or line up cards and then point to each one and label it. Lots of my clients like to line things up, so pushing would mean embedding language into that activity. If the child likes to sit and look at cards or photos (many of my clients do) then sit with them and say the names of the items on the cards. A way to expand this further, would be to require the child imitate your label before they pull out another card. This means if you say “car” they also have to say “car” before you let them pull out another picture.
*Recommended Post: Teaching Communication to Non-Verbal Children