My son, I will be the first to admit it, is a shameless flirt. He uses his big blue eyes and gorgeous smile to reel in any girl/woman/female-of-any-species within a three kilometer radius. I have often had to speak to him on the subject of how many girlfriends he is allowed to have at once. He can’t count yet but I think that the number ‘one’ is pretty easy to grasp – he currently veers more towards four.
That’s not counting me, my grandmother and my mother-in-law, always ready at his beck and call to prostate ourselves at his feet. Or bring him food. We are transported with pleasure if he just slightly glances in our direction and if he should smile and hug us, we are ready to do anything he wants, right after we’ve unmelted ourselves from the puddle state.
Yes, my son doesn’t have to lift a finger. Does the discipline come from his dad, you ask? Is the fatherly touch there to give him the firm hand he needs? Oh please. My husband is ready to tap-dance, juggle, waltz, or sing any Wiggles song, if my son just vaguely says something that sounds like ‘da’.
But despite being everyone’s favourite child, Michael has a long way to go before he can do the things that most parents take for granted. He can’t play with his cousins. When he was diagnosed, he barely acknowledged that they even existed. He would play with his toys, he would look at his fingers, and if someone came near him – he would move away.
Many people think that is the lot of an autistic child. This is what his life will be like forever, that he has no wish to make friends and will be locked into his world. It is thought that even if he learns how to read and write, even if he turns out to be super clever, he will never want to have a relationship with other human beings. That being antisocial is somehow part of his personality and that trying to encourage him out of it, is wrong. This is of course complete rubbish.
One of the most important things that early intervention does, is make social interaction easier for our children. By teaching them basic skills early, over and over, they become second nature.
What do I want for my child? I want him to have meaning in his life. He doesn’t have to invent a new branch of Western thought, he just needs to have a job that contributes to the world around him, he needs to feel loved and he needs to have meaningful relationships. With someone other than me. It doesn’t have to be a huge amount of people, but there need to be a group of them that he cares about and who care about him.
These are very long term goals. He is not there yet and may not be there for years. We have used these techniques to establish a great relationship with him ourselves – and he now has one with his therapists, and with his dad (who is, I am very happy to report, the favourite parent). But I do hope that he will have some meaningful friendships with his peers, and of course being myself, I have started working on this already.
Of course, indirectly, most things we do with Michael have to do with his social skills. You can’t play with your peers, if you can’t play, or if you don’t understand what they are saying. Imitation, joint attention, these are all things you can hardly to without – and skills that were completely lacking when we started our early intervention.
I have written elsewhere about how to improve your relationship with a child on the spectrum, and had a separate post about how we have started to improve Michael’s eye contact.
We have also taught him several other skills that have been very useful for his social skills:
When I look back at Michael’s baby videos, I can see some signs of autism – but no signs of lack of social skills. There he is, reading a book with his dad, looking at the book, then back at his dad, and at the book again. He knows he is looking at the same book that his dad is reading.
It is such an important skill – without joint attention and referencing, it is almost impossible to understand what someone else is trying to explain to you, and even harder to ‘read’ the deeper meaning under the words.
The way we taught Michael to start referencing, when he stopped doing it altogether, was with cartoons. I would take my phone, put his favourite cartoon on, and hold it out at arm’s length. I would then pause it, say ‘ready, set, go’ and on set he would need to look at me, then back at the phone, and then I would press play again.
Of course at the beginning he had no idea what I was trying to get him to do, so I would prompt him by moving the phone behind my head (his eyes always follow my phone to this day) and back out. After a while I would wait a couple of seconds to see if he did it himself, before prompting, and eventually it stopped being a problem for him.
Now, when he goes down the slide, he looks back at me to see if I’m coming. If he wants me to chase him, he stops and looks back at me, then watches me as I run away. The referencing skills are getting there – still a long way to go, but vastly improved.
Often kids on the spectrum, no matter where they fall on it, will struggle playing with their peers. They prefer iPads to other people – but this isn’t because they really only want to play computer games, they just might be more predictable and easier to deal with than their friends.
Michael has three cousins, very close in age to him, and he never plays with them. Even a few months ago, as soon as he saw them he would run away crying. Then he graduated to ignoring them (who are these peasants, and why are they bringing me toys, was his general attitude) and now he will stay on the side and watch them, but never joins in.
Yet I can say with certainty that there is nothing he would like more than to play with them. Chasing me up and down the house is one of his favourite things to do – he laughs so hard he nearly falls over – and if another child can be persuaded to play a simple ‘tag’ or ‘hide and seek’ game with him, his face lights up and he is the happiest I’ve ever seen him. I am convinced there is a super sociable little kid somewhere in there (much more sociable than me, I have always preferred to sit in my room with a book) and I just have to help him get the skills to be able to join in with others.
A good start is games like peek-a-boo, giddy-up horsey, humpty dumpty, or aeroplane. Anything active, involving cuddles, tickles, or being thrown in the air, we have used to encourage social interaction. We start off small (sometimes he initially hates these games, and then they become his favourite thing in the world), prompt him a lot, and eventually make more and more demands.
For example, one social game we play is called aeroplane. We say ready, set, go and when he makes eye contact on ‘set’, we throw him up in the air and swing him around like an aeroplane. These days we put him down and walk away for a few meters, so he has to start running at us on ‘set’ and then we swing him around.
With peek a boo, we started by covering his face with our hands, or getting him to cover our eyes (prompting everything) and then tickling him when he uncovered our eyes. Then we started hiding behind chairs or putting blankets over our faces, and uncovering. He loved this especially, so we would do the same thing, but a metre away, then two. Now he runs down the hall after me and finds me behind a couch, or runs away from me. I love how he looks back at me over and over when he runs away, as with this game he absolutely has to reference.
He has recently started doing this with other kids as well, it’s quite an easy game as long as they are patient enough to get his attention to begin with.
We recently introduced another program where he is learning to stay next to a peer, just sit next to them and continue to do tasks he has learned – things like puzzles or imitation. We bribe him to stay with treats and have found that after a minute of discomfort, he very happily sits there and performs just as well in all his programs. With time, we plan to increase the number of other children near him, and then to introduce games so he can learn to interact for increasing amounts of time, before preschool starts.
Asking for Help
The iPad has become a parents’ greatest enemy, and greatest helper, in the modern age. On the one hand, it can serve as a great babysitter in the evening while you prepare dinner. On the other hand, getting your kid off there and interacting with others can set off a tantrum so loud the neighbours call child services because they’re sure you’re sawing off your child’s limbs one by one.
Yet the iPad, and computer games, can be used to improve social skills if used correctly and if you’re prepared to outwait the tantrums.
They can be used for games that require social interaction – some games actually demand interaction between players. Shared interactions and values will create a sort of community for your child, which may be especially helpful if they feel they have little in common with other children that they see day to day.
For children that aren’t quite up to that stage (Michael can barely press a button on his iPad, let alone build an Avatar) the iPad can be used for motivation. Use anything you can. iPad. Food. Anything at all that motivates your child to learn, as long as you break it down into little pieces and constantly increase your demands. Rewards are not forever. You can fade them. But the skills they learn are for life.
For example, since he can’t change his cartoons himself but gets bored quickly, we make him ask for help – by creating picture cards with an iPad, or ‘I Need Help’ on them. This can be hard – you let him watch something for twenty second, then pause, and only give him more if he interacts with you or takes turns. There were many tantrums at the start with Michael until he realised they weren’t going to work.
We deliberately don’t teach Michael to handle iPads, or open his drink bottle, and keep his favourite snacks in closed boxes, so he has to ask us for help with each little piece. He gets to watch about twenty seconds of video, then we pause it, and he has to ask again. He gets one piece of bread and then we close it, and he has to ask again. Sure, independence skills are important, but he is quite motivated to learn these for himself and doesn’t need our help. His communication and social skills on the other hand are very delayed.
You will have to set up some very fake scenarios to improve social skills. For example, I know very well that Michael wants to have a drink of water. I still make him pick up the picture card for it and give it to me. I know that he wants me to change his cartoon – I still make him pick up the ‘help me’ card. I know what he’s thinking before he thinks it and I know what he wants five minutes before he wants it. But he won’t always be with me, and he needs to be able to tell people what he needs, even if he can’t talk yet.
Waving and pointing
Waving and pointing took us about six months. We would hold out Michael’s favourite snack and say ‘point to bread’, then fold his little hands to make the point, then reward him. Over and over. Ten times a day, seven times a week. It still took about three months until he could do it independently, and now he does it automatically. So we had to do it, in total, about 3000 times (at least) and he still only does it when we tell him, something that other children start to do by themselves when they are 9 months old.
He doesn’t understand that it is there to show preference either, all we have taught him is how to do it, and while he does it automatically with some items, he still usually reaches for the things he wants. We will have other programs later to teach him that pointing means he wants something, or prefers it, or wants us to look at it. At the moment we have a program for him to show us out of two items, which one he wants, by pointing. Gee it’s making me tired just thinking about the steps we have left.
Waving was very similar. We also prompted him to do it thousands of times, before he started doing it himself. Then we had a separate program to get him to wave when we said ‘hi’ or ‘bye’, when entering or leaving a room. And now we have another separate program to teach him to wave without ‘hi’ or ‘bye’ – to initiate it himself when he sees someone coming in or leaving.
Yet the great thing about ABA therapy is that with these kinds of skills, many of which simply require many trials, he doesn’t get tired of it. He comes up to me, ‘points’ to bread, grabs it, and leaves to do his own thing. It has become second nature for us to ask him to point to things, or to get him to wave to us when we come in or out, and I can see it becoming second nature for him to do these things. Eventually he will do them without thinking, just like the other kids.
With other things, like social games, repetition is not the best way to teach them. I tend to intersperse social games between the other trials so that when he is in the mood to sit and point to things, he does that, and when he feels like running and chasing me, he does that. Parents make the best therapists because we can generalize skills so easily and do appropriate programs when our little one is in the mood.
The real thing to take away though is that you have to keep trying with social skills and work your way in baby steps. Also that sometimes you will need to ignore a tantrum, turn off that iPad, and make some demands. The things they hate today may be their favourite things tomorrow.