Story
Most infants and children follow a natural trajectory of development. Milestones have been identified as a child acquires skills along this path. It is a trajectory that leads to learning readiness and successful school outcomes. It includes the social competence needed to navigate uncertain and unpredictable exchanges with peers and community members. It is a shared set of customs that are agreed upon as acceptable within a culture. Encompassing an essential skill set, it makes lifelong independence and survival possible.
A person with autism may not be inclined to follow this same trajectory. The strength and variety of autistic features unique to that person may result in a developmental path that veers in a different and unique direction from the start. As development continues the path may become increasingly different and in some cases limiting.
Perhaps the most helpful intervention strategy would be to identify missing and delayed milestones and attempt to replicate the natural learning experiences that might lead to acquisition. Autism friendly lessons and activities could be tailored to accommodate a person's unique learning style and sensory needs. The following are my observations and ideas for possible interventions. They are offered here for discussion only and not as recommendations for treatment.
Framework: Mental States
Mental states include thinking, knowing, believing, expecting, and guessing. We suspect or assume a person is engaging in these mental activities when we talk about "theory of mind" and "taking perspective". We expect that others will have different thoughts and personal motivation from our own. It is critical for social interaction, academic success, and independence as an adult.
Steps, Empathy, Shared Interests, Safety, and Social Media:
- Four steps in perspective taking a person may follow in a social interaction begin when two people enter the same space. The first thing they do is think about each other. Then each person considers the other one's motives and intentions. If one person is suspect then the other will monitor carefully. Next, each one speculates as to whether they are thought of favorably by the other (keeping in mind how past interactions were received.) Finally, they each continue to watch each other and alter their course of action if it will have a more positive reception.
- As a person contemplates what someone else is thinking, he or she will also consider the feelings/emotions of the other person. The emotions can be contagious and thoughts about how another is feeling may color how that other person or the situation is viewed. This empathy may cause a person to make a more kind or helpful response or course of action.
- We are most often inclined to think and learn about another person's interests and concerns. Even though we are not drawn to something to the same degree it is in our nature to be inquisitive about what another person is passionate about and what they are engaged in. It is often the first step toward friendship.
- We routinely assess and monitor the motives and intentions of others. If they are benign or positive we can move forward without fear of harm. If they are suspect, we alter our thoughts, comments and actions. We evaluate the risk and take necessary steps to protect ourselves. Anticipating danger from others requires good assessment of their thoughts, motives and intentions. It is a survival skill and determines how independent we become as adults.
- Social media now presents a new arena where interaction can be risky. Sending messages that are not offensive can be difficult. Text often requires more careful wording and a response is not always immediate. Nonverbal communication is missing in text only media. Knowing when something was offensive or what was offensive is much more difficult than in face-to-face interaction and makes it hard to repair a mistake. Getting to know the person you are communicating with can be difficult especially if that person is deceitful and has sinister intentions. Even trusted acquaintances can engage in unfriendly exchanges with peers and as messages are rapidly shared bullying can erupt and cause much social harm.
Strategies for Activities, Lessons, and Materials:
- Children can have frequent opportunity to interact with peers and adults with comments from caregivers to explain others behavior.
- When reading picture books to children, caregivers can frequently ask "why" to explain the characters' actions. They should also ask the child to make predictions and discuss how and why characters would behave in that manner.
- Caregivers can frequently label dangerous situations and people who may wish to do harm.
- Frequently ask a child to make predictions and assist with identification of the perspectives of those involved in a situation.
- Encourage friendships with frequent time for play and social interaction with peers that are seen often.
- Help a child understand when something they say or do causes a problem with another person in the situation. Talk about the other person's thoughts, feelings, and intentions and why they were offended or harmed.
- Older children and young adults can be given guidance concerning texting, email, electronic chat, and image exchange.
A person with autism or other developmental delay might:
- be reticent in participating in activities that involve social interaction.
- interact with others with no attempt at conversation.
- ignore nonverbal communication from others involved in an activity.
- not be interested in how others in a situation respond to his or her actions.
- appear to be unfeeling or uncaring about others' pain or suffering.
- persist in dwelling on preferred topics in conversation when others show signs of boredom or discomfort.
- have difficulty understanding or using statements in social situations.
- have difficulty understanding or using pronouns in social situations.
- have difficulty understanding or naming feelings/emotions in social situations.
- have difficulty understanding or answering wh- questions in social situations.
- use poor nonverbal communication in conversation.
- have difficulty processing a partner's message and then generating a response in a timely manner.
- not manage turn-taking properly by interrupting, speaking to long, or not responding.
- struggle to maintain or shift topic in conversation.
- initiate topics that are taboo or culturally insensitive.
- struggle to understand rapid exchanges in animated cartoons, T.V., and movies.
- struggle to comprehend written dialogue in story books, cartoons, and novels.
- struggle to make friends that have similar social interaction skills.
- enjoy the lower time constraints and lack of video in texting, email, electronic chat, and image exchange.
- struggle to comprehend and follow guidance concerning texting, email, electronic chat, and image exchange.
- not be aware of the impact or negative reception a message may cause with texting, email, electronic chat, and image exchange.
- engage in relationships (through social media) with unknown persons who are deceitful and have intent to bring harm or injury.
- be victimized in various forms of social media.
- be preoccupied with sensory sensitivities.
- lack assumed skill levels in related areas.
User Friendly Strategies for Activities, Lessons, and Materials:
- Organize play opportunities with peers that can be accommodating and understanding of the help that might be needed.
- Read picture books and analyse each page for thought, emotions/feelings, motive, and intent.
- Read picture books and determine cause/effect and prediction aspects for each page. Ask "why" and "what happens next".
- Read dialogue in structured role-play situations and analyze for thought, emotions/feelings, motive, and intent.
- Read dialogue in structured role-play situations and analyze for offensive and harmful statements.
- An assistant can be used to prompt the child in conversation.
- Practice use of good nonverbal communication in conversation.
- Practice use of good turn-taking and topic maintenance in conversation.
- Develop topics and questions/statements that might occur in conversation and can be used to avoid dwelling on a preferred topic.
- Assist the person in identifying emotions and ways to describe feelings in him or her self and others.
- Identify and review often the taboo and culturally insensitive comments that should be avoided or used with only certain audiences.
- Identify text messages in social media that might have negative impact or unintended consequences.
- Discuss how predators may pose as friendly social media persons.
- Discuss steps to take if a predator or bully is engaging you on social media.
- Review safety rules for social media and restrict use of devices if risky behavior persists.
- Observe and detect sensory sensitivities to materials and environment and alter as necessary.
- Observe carefully to detect competencies in order to know what they don't know.
