alt="image"/> If he is holding a toy, act as if he is showing it to you. Hold it up (though don’t necessarily take it out of his hands) and talk about it.
a spinning top
a feather
a glove puppet
a bubble machine
a party blower
a yoyo
a sticky ball (you threw it against a wall and it slid down slowly!)
some Sellotape (my son loved the sound)
a magnetic spinning dolphin.
You might try holding up two items and encouraging your child to point to which he wants – physically mould his hand into a point shape if necessary. Throughout the day encourage this when he goes to grab something, mould his hand into a point and then touch the item before giving him it. Reinforcethe gesture by saying, ‘Point to…[whatever it is he is requesting]’.
NOTE: Always be wary of including something your child likes to the point of obsession otherwise this becomes more important than you or the interaction!
Moving on
When you have found a number of ways to access your child’s attention for a few seconds, use these to associate them with another activity, in order to prolong the moment. What you are doing is using something your child finds highly pleasant (for example tickling) and making him associate that with something he probably wouldn’t respond to originally – for example, any one of the following:
The case below illustrates how this might be done.
Individual example: Andrew
Three-year-old Andrew loved to be tickled and his parents loved to tickle him. During this time he squealed with delight, he looked into their faces, he allowed them to touch him – he was ‘with them’. When the activity stopped, Andrew ‘disappeared’ again. It was desperately frustrating for his parents to know that he could enjoy sharing space but that this was limited simply to being tickled. They had no idea how to move this on, yet were aware that somehow they needed to develop this pathway. First they increased the number of times they tickled and rough-and-tumbled. They had to let go of their idea that this is not how you would interact with a non-autistic child all the time.
Then they began to pair the tickling with another activity – blowing bubbles. Whilst Andrew was being tickled by his mum, his dad would start to blow bubbles. Andrew didn’t seem to notice at first but gradually he began to look intently at the bubbles. When he did this his mum would slow down the tickling game to let him focus on the bubbles. During the sessions, Andrew’s attention would flit between the two, and he began to touch a specific parent and seek out brief bursts of eye contact with them, depending on which activity he wanted, bubbles or tickles.
The bubbles were then moved to follow a bout of tickling (whilst Andrew was still very much with them and enjoying it). Andrew’s parents found that he was still receptive to the bubbles and amazed them by reaching out and laughing whilst he tried to pop them. During this time his mum and dad built in long pauses to allow Andrew to communicate that he wanted the game to go on. They were always responsive to whatever gestures and speech attempts he made by saying, ‘More bubbles? – yes!’ If they felt he was moving into his own solitary space again they would try a tickle, always responding to his lead. If he pulled away they would gradually tail off. If he responded they would keep going. Andrew was always left in control of the duration of the activity.
After a couple of weeks, Andrew responded to the bubbles without having to be tickled as well. Now Andrew’s parents had a second pathway to access their son; by associating new activities with the old pathways (tickles and bubbles), they continued to have positive results. The next thing they chose was a singing commentary. While Dad blew bubbles for Andrew to pop, Mum would begin a singing commentary (to a familiar tune such as ‘For he’s a jolly good fellow’) on what was happening. It went something like this:
‘Andrew’s on the sofa. Andrew’s popped a bubble…look, look, a big bubble… Andrew’s popped a bubble…Daddy’s blowing bubbles…more, more, more…Daddy’s blowing bubbles…pop, pop, pop…a bubble on the window, a bubble on the floor, look, Andrew bubbles more, more, more…’
Andrew’s mum sang the commentary using lots of repetition and rhymes where they were possible, all the time commenting on what Andrew was actually doing. It took a couple of sessions before she felt comfortable doing this, but soon found a style that worked and was fun.
Again Andrew originally appeared to ignore the commentary and only focused on the bubbles, but gradually he began to look at his mum to sing as soon as the bubble game commenced. Once it became clear that the commentary was as important to him as the bubbles, this was then moved on to singing commentaries about other things during the day, for example when Andrew just meandered about the room she would try a commentary on what he was doing:
‘Looking out of the window, what can you see? I can see a house, I can see a tree, touching the cushion, touching the floor, touching Mummy’s knee.’
Over a period of a few weeks, Andrew’s parents had created a collection of activities that not only gained Andrew’s attention and enabled him to attempt communication, but that were so enjoyable to him that he allowed them to
