It isn’t about leaving a child to discover an activity, its limits and potentials by himself (though learning to discover these things together is a definite goal).
It isn’t about these things because, in a play context, choice, freedom and discovery are simply not the things that motivate children with autism to play in the way they motivate their non-autistic peers. Children with autism need structure because despite their many differences, in general they have impaired motivation to interact, learn and play. They have rigid and repetitive patterns of thinking and therefore of talking and playing, and are often motivated to preserve ‘sameness’. Coupled with a resistance to being directed and a need to take control of as many aspects of their immediate environment as possible, it is not difficult to appreciate how being part of a learning and playing environment that advocates spontaneity, free choice and independent discovery simply is not appropriate for a child with autism.
What does ‘structuring play’ actually mean and how does it work?
You might feel that this sounds fine in a therapeutic or educational environment, but how does this work in a busy home environment with a three-year-old? We shouldn’t feel that the only way to help our child is to follow a specific private programme executed by a therapist, not a mere mortal parent! As primary carers for our children we can learn how to structure their play – it’s about choosing an activity, looking at how your child already engages (or doesn’t) in the activity, whether he plays appropriately or inappropriately, how he interacts with you (or doesn’t) during these times and how you can make improvements. It’s about looking at his day and working out how you can steer him into constructive interaction and play for more hours than he currently does. Introducing structure is also about being aware of what makes him distressed and working out how communication can be improved to make him feel safer by making his day seem more predictable and less chaotic. It’s also about taking some control yourself; making your child aware that he is a part of a functioning family, with the comings and goings that this involves, and not always the nucleus that the rest of the family revolves around. Giving your child structure allows you to do this in the kindest way.
Structuring play works by systematically breaking a play activity into its component parts so that it is no longer a jumble of language, objects and actions that has no meaning for your child. By breaking it down into very simple elements you give your child a chance to work out what each element represents – you give him the chance to interpret the activity and give it meaning. Fundamentally you are giving his brain a chance to keep up with processing incoming information. I expect achievements will vary according to your child’s potential, but even the smallest of successes will justify the effort. This is how structuring an individual activity works. Throughout the book I also refer to structuring the day as a series of activities. These will not all be play activities – the day is represented in pictures showing the sequence in which they will happen, including the particular play activities that you have planned for that day.
Creating play opportunity – setting the stage
Each of the following chapters in turn draws your attention to sensory problems that may hinder playing with that particular activity and the importance of checking the play environment, so I won’t repeat this again here.
Remember to be responsive to your child’s level of tolerance to direct requests – if he is resistant, pull back; introduce the activity that you have planned into the day ‘indirectly’. Play alongside your child as if for your own pleasure, set up a duplicate activity within his reach and keep the session very short (one or two minutes at a time). If you feel that introducing structured play and learning is ‘beyond’ your child at the moment, concentrate on the less invasive forms of interaction, such as the activities described in Chapters 7 and 9, as well as the ideas on ‘sharing space’ detailed in Chapter 2.
When you begin systematically to ‘teach’ a child with autism to play, it helps if you have worked out a few things beforehand:
Know exactly which objects you will be using – ‘exactly’ means just that, have ready only the toys/materials that you will need for that particular activity. Decide whether things such as the box they come in will be distracting and, if so, remove them.
Know what the play area will be – the living room floor/a table/a tray top/a rug. Does your child need a prop to remind him that this is where his focus of attention will be, a special cushion to sit on, or a picture card reminding him to stay seated?
If you are using picture prompts (the importance of visual supports is explained at the end of the chapter), check they are not confusing or ambiguous or that your child is not interpreting them too literally. See Chapter 4 for lots of ideas on making the most of your computer to access and make visual supports.
Are you going to use a reward or reinforcer for your child after he has completed an activity – something tangible to motivate him to attempt it? Do you have a card to communicate this to your child? For further details on reinforcers see Chapter 5.
How long do you expect your child to engage in the activity? How simple or complicated are your goals? What actions and/or interactions do you specifically want your child to achieve? This may be something as simple as turn-taking with stacking rings or as complicated as an imaginary play sequence with a set of figures.
When you have answered these questions and have the materials and objects to hand, you have set the stage.
Breaking play down into tasks
Once again this sounds like a technical term for a common-sense approach to working with any child with a learning disability. Even for children without additional learning difficulties, their autism impairs the ability to generalize and learn. To break down a play activity we have to look at it as a series of tasks and teach each task separately. This may sound like taking play and removing all the fun – the hard part is not breaking the activity into its separate tasks, it’s keeping it fresh and lively and motivating. If your child picks up on your voice being desperate for him to comply or worse still annoyed at his non-compliance, he’s likely to resist.
The following example illustrates these points.
Playing the magnetic fishing game
The goal – to play ‘turn-taking’ with a magnetic fishing game.
The materials – magnetic fishing games, which are available in many toy shops. Do remember to get an easy-to-handle one or, alternatively, make a simple version yourself by doing the following: Cut a piece of fabric or card into a pond shape. Make six cardboard fish with paper clips attached to their mouths. Make a rod from a piece of dowel and string, and attach a strong magnet to the end of the string.
The tasks –
To lift the rod up slowly with the fish on, after the parent has steered the magnet to the fish.
To attach the magnet himself with his hands and then lift the rod clear.
To attach the magnet by dangling it over the fish.
To ‘turn take’ with two fish.
