The more I spend time on therapy with my son, the more I am convinced that he can learn anything – the trouble is motivating him to try.
Whether it’s playing with puzzles, matching, playing with toys – any program Michael masters eventually. It is broken down for him of course but if he attempts something, he eventually learns it. He comes out of a therapy session fresh and energetic. He runs around, laughs, spins. He does a lot of this within the session as well.
I, on the other hand, come out mentally, physically and emotionally exhausted. I am a wreck. Yet I only do therapy with him for two hours, and he does five hours per day. Why am I so tired? Because I spend the entire session trying to motivate him.
I do it because once it works, boy does it work! His learning rate is astronomical. Without ABA therapy, he learns nothing. He stares at his fingers and he runs backwards and forwards all day. He gets incredibly bored doing these things but can’t seem to stop doing them and try something else. With ABA therapy he has learned to look at a book for 60 seconds, to do a complete jigsaw puzzle, to figure things out on his own. He has learned to communicate if he wants something rather than throwing a tantrum. He has learned to tolerate many new situations and hasn’t had a proper meltdown in about six months. Probably longer, I just can’t remember the last time one happened. He went from a developmental age of about 3 months to a developmental age of 14 months after six months of therapy. So if I have to stand on my head to get his interest, then that is what I will do! And luckily, I have many wonderful therapists to help me do it.
His toys are awesome. The entire Fisher Price collection is represented, as well as V Tech, and other brands that I had to get from obscure corners of the United States. I have purchased from Kmart, Kidstuff, Special Needs Toys (website), Amazon, and everywhere in between. Anything to interest Michael. There’s a bean bag, trampoline, water beads, every type of sensory stimulation.
Unfortunately Michael is sublimely indifferent to the charms of a toy or bubbles. And of course he cares even less about ‘social approval’ or what I think about his skills or what he should or shouldn’t be interested in. So we have had to come up with other ways to motivate our little one, and we are constantly looking for new things.
Food, Glorious Food
I remember in English class covering 19th century literature, and the angel/prostitute dichotomy – that a woman in any novel was either perfectly wonderful and virtuous, or absolutely awful devil women. Michael hasn’t read any 19th century novels yet but he has this same attitude about food. There are ‘angel’ foods like his favourite fruit and chia bread from Baker’s Delight, soy milk, biscuits, and increasingly steak as well. Then there are devil foods (everything else). Luckily with our food program, he is expanding his repertoire of foods he likes, and even introducing new concepts like foods that are ‘neutral’ – neither angels nor devils. We’ll make a modern man of him yet.
The great thing is that as his ‘repertoire’ of neutral foods increases, some of them become ‘favourite foods’ and the ‘favourite’ foods become absolutely irresistible.
They are wonderful prizes to use in therapy. And they work very well because they are available only in therapy – not outside, and never ‘for free’.
Food is certainly one of Michael’s greatest passions. What makes it great to use for motivation is that you can break it up into little pieces to keep it working as motivation for longer (we cut his fruit and chia toast into about 40 little cubes) and it’s limited. It’s psychologically easier to give one little piece of it than to give a whole piece of toast and limit him to one bite, for example.
This means that even if one of the favourite foods is not very healthy, you can still use it. Just limit it to one cookie, and break it up into tiny little pieces.
If you are lucky enough that your child actually enjoys toys, go for it. I am very jealous. All you do is use the toy to get your little one to sit down near you, then gradually ‘remove’ it (yes, at the beginning this involves a lot of kicking and screaming) and only give it back after they do something for you. Then take it away again.
The way you can tell if a toy is motivating enough, is you have to see if the child comes to you for the toy.
For example, in Michael’s therapy room – we have a ‘therapy mat’, on which we do ‘therapy’. Any time Michael wants to leave the therapy mat, he gives me a ‘GO’ card and he can go immediately. He is always free to come and go and I will never hold him in place (unless I have already given him an instruction, then he needs to first complete the task and then he can leave, but this is very rare).
I will then put some toys in the middle of the mat and if he comes back for it himself (I will never force him to go back on to the mat) then that is the toy to use.
When Michael was a baby I swore to myself I would never give him any screen time until he was two, and even then to limit it to half an hour per day. Don’t laugh, it’s what all the parenting books said to do. I seriously considered ‘screen time’ to be lazy parenting, harmful to a child’s communication skills and generally just a tiny step short of throwing your child in the bin. In my defense, I think many new parents are a bit black and white like that.
I have since turned to the iPad as my hero and my salvation. I have used cartoons as a great motivator to teach Michael almost all of his programs, as well as helping me to teach him to eat, and to tolerate the presence of other kids. To parents that aren’t convinced of the iPad’s benefits, remember you can always ‘fade’ a prize. I no longer have to use it to feed Michael and I use it a lot less for teaching him programs.
Screen time is temporary but the skills it teaches are for life.
In fact there are some fantastic games on the iPad specifically designed for children with autism that teach them valuable life skills. There is an App that specifically lists the other apps that are good for children on the spectrum – my favourite one at the moment is the Touch Trainer, which is a very basic and easy game that taught Michael how to touch the iPad to get an effect. There are ‘model’ videos that teach a child social skills and communication. You can use them for flashcards and as a sort of PECS book to request items or food.
Of course, they also allow my husband and myself to go to a restaurant with Michael and let him chill out if he gets overwhelmed.
The one thing to keep in mind with them is that they are hard to take away. The way we use the iPad with Michael is to turn on his favourite cartoon (he loves anything by Littlebabybum, the Wiggles, Kids Camp and Dave and Ava) and turn it off after ten seconds or so. If he gets something right, he gets it for twenty seconds. If he needs help or doesn’t perform as well as he can, he only gets it for about two. We are very strict with it and after a few initial tantrums he is used to it and completely fine. He only watches them as bright pictures anyway so the loss of meaning doesn’t make a difference for him.
For an older kid, you can lengthen the interval. For example, you may give them a five minute period on the iPad. But you would also make more demands – for example, most older kids will have a ‘token’ system and if they earn ten tokens, then they get time on their computer game.
No one on earth knows your child better than you. Your little one may hate all the things I’ve mentioned above but I can guarantee that you already know what prizes would work for them. Other things that work with Michael are physical, social games.
If he gets restless, I might take him outside and give him piggy backs, or put him on the see saw or the swing. The same principle applies though – you can only use something you can limit access to. So I might push him on the seesaw a few times, then wait for eye contact, then go again. Or I might say ‘turn around’ and when he does it I give him a piggy back ride.
Just think of what makes your little one laugh, and use it to your advantage. Never give them anything ‘for free’, and always leave them wanting more.
Constantly reevaluate your prize
Every parent knows that just because Peppa Pig was your baby’s favourite toy in the world last week, doesn’t mean it is this week. It doesn’t even mean he will look in its general direction. Michael tends to look at his old passions in a similar way to Casanova – sure they were nice at the time, but I’ve played with them at least three times now and I don’t know what I was thinking.
During a session, most of my energy goes towards finding fun rewards for Michael. A cartoon that he likes in the first five minutes will be ‘totally last season’ in the next. Maybe he isn’t hungry. Maybe he doesn’t want cartoons and just wants to be bounced up and down, and my physio bills just keep climbing. Or maybe he just wants to sit quietly and watch the Wiggles. Whatever it is, don’t get stuck on the thing that worked last time.
Unless you’re lucky enough and your kid has a special interest that they don’t let go of. Then knock yourself out. Lucky you.
Give Good Things for Trying – Give Better Things for Succeeding
Differentiating your reinforcement – a technical term for giving good prizes in proportion to the effort required – is a necessary part of teaching. The simplest way to do this is to give one little piece of chocolate for a try and two or three for a successful independent trial. I might show Michael a cartoon for a few seconds if he lets me prompt him to play with a new toy, and show it to him for twenty seconds if he plays with it himself. It’s all about teaching him that any effort gets a reward, but a bigger effort gets a bigger reward. And when he eventually succeeds (and he always does) I throw him a major party.
I like throwing parties. It’s fun. And although twirling a 16kg toddler around isn’t as easy as it sounds, I am still always happy to do it as many times as I need to.
Always Fade Your Prizes and Increase Your Demands
When I started working for the government several years ago, I remember the bribery lecture. Actually it went on over several days, and a lot of emphasis was placed on never accepting anything from the private sector. Ever. Not even a coffee, or a bottle of wine. I’m pretty sure that if we ever went to a conference with someone not from government, we wouldn’t be allowed to accept a cup of tea.
And of course there’s a great reason for that. Corruption and bribery is a slippery slope. You start out accepting a cup of coffee or a chocolate, and you end up in an article by The Age on the Unaoil Scandal.
Bribery does work. And it works best if you continually but very gradually increase your demands.
A similar principle works with small children.
The trick is to constantly ask for more, and give less.
How does this all work together?
For example, let’s say I want to teach my son to play with a toy xylophone for thirty seconds and he doesn’t want to even sit near it. The idea of xylophones and all xylophone-related activities fills him with disgust. What do I do? Do I give up in despair and decide that he will clearly never be a musician, and maybe that’s a good thing since I want him to have a living wage one day?
I get his favourite snack and when he comes over, I ask him to sit down and give him a xylophone stick. He promptly tries to eat it. I guide it gently out of his mouth, put the right end in his hand, and prompt him to hit the xylophone. Then reward. Then again. Then once he can do that I try to hold him by the elbow. By the top of his arm.
Then he plays it once himself. I throw a party and give him two or three pieces of bread. But only a few times. Then I start to expect that he can play it himself, and give him only one piece, but prompt him to play it for five seconds straight. Then for ten, fifteen, twenty, and finally thirty.
Then I start to introduce tokens. He gets one token for playing the xylophone for thirty seconds. Then another token for another thirty seconds. And then he gets his reward. Five tokens. Ten. Sometimes the reward is food, sometimes I play video games with him, and sometimes I give him a piggy back.
Gradually, he grows to love music. It is, itself, the reward. Over weeks and months, he’s learning and playing at the Opera House. He gets an Aria Award and thanks you in his acceptance speech. Buys you a house in Darling Point. The end.