add picture cards for him to label on the reverse side of the fish, or to put numbers on the reverse side. Whoever has the highest number, wins.
Even though this is highly structured in some ways, there are no set rules. Some children might get the hang of an activity very quickly and skip straight through all the tasks; others might need extra help from you in motivating them to look at the activity and attempt the first task. Accomplishing each task can be seen as a separate play session – a general ‘fishing game’ picture prompt can be used for each session. The first example session might go as follows:
The materials are set up. Mum and Adam collect the fishing game picture card off his diary board (see later section, ‘Structuring the Day’). The next picture card is of Adam’s reward/reinforcer – listening to music.
| Mum: | Now it’s time to play ‘fishing’. Let’s get the card, Adam. (Adam ignores her and picks up the music card.) |
| Mum: | Yes Adam…after the fishing game we’ll play music. (Adam still resists a little.) |
| Mum: | I can see…a yellow fish and a rod! (Mum takes the fish and pretends to make it swim. She then picks it up and drops it, saying ‘it’s got away…come back naughty fish!’…she plays as if for her own pleasure.) (Adam stands on the fish.) |
| Mum: | Well done, you caught it…it’s got your toes! (Mum makes the fish tickle Adam’s toes.) (Adam sits down.) (Mum puts the rod in his hands and closes her hand around his. They lift the fish out together with a ‘One two three…wheee!’ Mum puts the magnet on the fish and lays the rod on the floor. Adam stands up and starts to walk away.) |
| Mum: | It’s ready to go ‘One two three Wheee!’ Adam – (Mum points to the rod) Adam do ‘One two three wheee’, then listen to music. (Mum physically guides his hand to the rod.) (Adam finally crouches and lifts the rod – Mum touches his elbow, saying ‘s..l..o..w..l..y’) |
| Mum: | Yes, well done! – Adam did it! Let’s listen to music. |
The next two or three play sessions could be spent trying to make simply lifting up the fish fun and motivating so that completing the play activity is not simply a means to reaching the reward. Be as silly and creative as you can be:
This is where parents and carers really have to work hard. Non-autistic children simply don’t need to be taught step-by-step that this is a fun activity – understanding the meaning of the game and what it represents just happens, and any additional fun is just that…an extra bonus. Children with autism will struggle to understand: ‘Why do I need to do this thing?’ Your job is to teach your child that playing, and interaction, are fun!
On the basis of this example, any activity (not necessarily just play) can be broken down into a number of tasks that can be taught separately. In the same way that back chaining can be used to complete jigsaws (your child places in the last piece, then the last two pieces, etc.), it can also be used for any play task. Your child’s first play session is completing the last task after you have guided him through the rest, i.e. he lifts the rod after you have attached it to the fish and put the rod into his hand. After he understands and can do each stage, take him back one more step, i.e. next stage he attaches the fish to the magnet, then next stage he dangles the rod over the fish to catch it, etc.
Analysing play activities in this way takes some practice, but very quickly becomes simply your way of playing with your own child. You may already have been doing this to an extent without even realizing exactly what you were doing!
Applied behavioural analysis (ABA)
Many readers have probably heard of Lovaas or ABA training. This is one of the long-standing therapies that have a central theme of structure which has proved positive for many children. We ourselves considered the programme but decided that for us and our little boy this was not going to be the right decision. We were, however, in a good position to offer a high level of structure and one-to-one attention, at his crucial stage of early development and felt strongly that we also had to create a learning and playing environment that accommodated his autism to some extent. The choice to go down this route is highly individual, but any parent who hasn’t heard of the therapy should at least research it. In brief, the home-based programme consists of teaching sessions conducted by a team of helpers trained by an ABA supervisor. The therapy can be intensive – up to 40 hours a week – and costly (though there are ways of trying to get help with this). Children are taught skills in a similar way to some of the techniques that I describe in this book – breaking them down into smaller tasks and using reinforcers to motivate. Many programmes are ‘play’-orientated and have come a long way since the older style ‘behaviour’-orientated programmes which have received negative publicity in the past. ABA is a big commitment emotionally, physically and financially, but for some families it is the preferred route. Those with children on the programme are usually more than willing to let you see how it works and to share their experiences. Like all therapeutic routes, parents need to explore all the possible ramifications and make an informed decision whilst trying not to get bogged down by the latest ‘recovery’ programme. This book is about demonstrating that as parents we have the power to help ourselves to knowledge and information in order to help our children.
For more information on ABA and other therapeutic options see the resources at the back of the book.
Structuring early learning
Non-autistic children have a curiosity and motivation to understand as much of the world around them as possible. Their developing brains cope with new concepts and levels of understanding as soon as they are physically ready. Their ability to think and reason is aided by a stimulating and attentive environment as well as their own biological make-up.
If, however, that very biological make-up is impaired in a way that takes away the motivation to understand and make sense of the child’s surrounding world (the way an autism spectrum disorder does) then the process of learning is disabled, regardless of whether the child’s intellectual reasoning is intact.
This makes the prospect of creating an environment to support learning much more of a challenge. Most parents of children with autism are in agreement that their child needs to have proactive input into helping him learn and play and communicate as early as possible. Even though these three elements of development are very much entwined, we might see them also as separate arenas that need equal attention. From the outside, activities aimed at developing play skills
