Fast forword helps in the development of speech if ond, dyslexia, speech disorder, alalia, autism, ADD - attention deficit, phonemic hearing, nsv, races, zrr, zprr, ffn. reviews! Methods of teaching children with autism Teaching children diagnosed with autism

Grechikhina Tatyana Sergeevna, teacher of physics and technology of the highest category, State Budgetary Educational Institution “School No. 1741”, Moscow.

Childhood autism is a special disorder of mental development. Its most striking manifestation is a violation of the development of social interaction and communication with other people. In autism, time orientation is often impaired. Events of the present are mixed with the past, real with fantastic (especially in children).

K.S. Lebedinskaya understands the term “AUTISM” as “separation from reality, withdrawal into oneself, absence or paradoxical reactions to external influences, passivity and hyper-vulnerability in contacts with the environment.”

Autism occurs more often than isolated deafness and blindness; in recent years, in domestic and foreign literature, the figure is 15-20 cases per 10 thousand newborns, and in boys autism occurs 4 - 4.5 times more often than in girls.

Autists are “people without skin.” On an emotional level, they perceive everything not like we do, but much more acutely. The unknown scares them. New premises, new person. They are very anxious and emotionally unprotected. Because of this, they are immersed in their own world and do not make contact, they avoid communication.

The behavior of an autistic child is characterized by pronounced stereotypy and monotony. First of all, this is the desire to maintain the usual constancy in the environment: eat the same food; wear the same clothes; walk along the same route, etc. Attempts to destroy these stereotypical living conditions of a child cause diffuse anxiety and aggression in him.

If there is a child in the class who does not play with his peers, avoids communication, is afraid of getting dirty, and covers his ears with his hands when hearing sounds, advise the parents to contact a specialist.

There should be no surprises for autistic children. In order for an autistic child to have the opportunity to gradually master the learning situation, it must be as structured as possible. With the child (with the help of a schedule), the sequence of preparation for the school day, for the lesson should be specially worked out, if necessary, a visual diagram of the organization of the workspace, a set of necessary educational materials, and the sequence of preparatory actions should be drawn up. Pictures are commonly used to display the activity schedule of autistic children. Predictability helps an autistic child focus on learning.

An autistic child experiences enormous difficulties in organizing social contacts, but he also experiences a need for them. When communicating with an autistic child, you need to express yourself as clearly as possible. . Use the simplest words that are easy for autistic children to understand. It is advisable not to use the particle NOT.

You need to talk to an autistic child in a calm tone, as any increase in voice can cause anxiety and restlessness in the child. When communicating, physical contact should be kept to a minimum, as autistic children do not understand sign language and will not be able to correctly understand your touch.

The environment in which a child with autism is taught should be calming and free from clutter.

There must be an area in which the child can retire for a while.

For productive learning of children with autism spectrum disorders, it is very important to maintain certain principles for constructing each lesson.

The first prerequisite is the presence of clear boundaries of the lesson. It is unacceptable for recess to flow smoothly into the lesson, as this does not provide an opportunity to tune in to another activity in time.

At the start of teaching children with autism spectrum disorder, it is very important to maintain a unified lesson algorithm within one subject. . This means that at first each lesson should contain common structural components (for example: completing homework, presenting new material, independent work, explaining homework). Over time, new elements can be added to the established structure of the lesson, such as: work in pairs, work at the board, work on a project, etc.

The structure of the lesson assumes:

Having clear lesson boundaries;

Maintaining a single lesson algorithm within one subject;

The presence of dynamic pauses;

Summing up the lesson.

Remember, all children must finish the lesson at the same time.

It is important for the teacher to understand what part of the lesson the child is “involved” in what is happening, at what point it is necessary to give a rest, switch to another activity or insert a dynamic pause . This will give the child the opportunity to switch gears, relieve muscle tension and recuperate energetically.

Despite the fact that each of the children has an individual education program, they are all taught in the same class. Therefore, it is very important to choose the size of the task so that the children finish the lesson at the same time.

At the end of the lesson, it is recommended to summarize the lesson. To do this, do not carry out the standard procedure of “remembering what you did in class,” but write out supporting phrases from the content of the new material in order to once again focus attention on the new material.

Let's remember and repeat - it helps to prepare the child for the lesson. Let's repeat - and we talk through all the necessary concepts and definitions with the child.

What new things we learn in class is aimed at serious work and long-term memory, because On the last page of the lesson you will have to answer the questions posed.

Children cannot be pulled out from behind the wall, they must be lured out. Everything a child does under pressure is useless!

The environment in which an autistic child lives and studies must have the most developed semantic structure, that is, the child must be made to understand why this and that is being done. Nothing should happen to him mechanically.

Children with autism spectrum disorders have a specific perception of oral speech. They cannot always immediately understand what adults want from them. At the stage of misunderstanding, situations can be aggressive. The self-defense reflex is activated.

Since the high school curriculum involves the assimilation of a huge amount of oral material, it is important to accurately understand:

What part of the information given orally does this or that child understand;

Which instructions are better absorbed and more often followed;

In what form should the question be asked in order for it to be understood?

When receiving a task, the first reaction is “I won’t do it!” You need to talk to the child and explain. And then another reaction: “How to do this? I can do it! Yes, it’s quite simple!” Nothing should happen to him mechanically. Any action is planned for something that will be very good. Any action taken is also commented on and interpreted; then they return to it, and it is evaluated again from the point of view of its meaning, benefit, and the joy that it brought to everyone.

Any skill is mastered meaningfully, for immediate practical use in life now or later, in the future, when the child grows up. Teaching children with autism should focus on positive motivation.

It is important to follow the child’s natural need for cognitive activity, and not impose it. Training should take place in a positive atmosphere.

More often offer children tasks that they would enjoy doing. Requiring a child to perform uninteresting or more complex tasks should be done carefully and in doses, since constant tension leads to somatic or psychological problems. In technology lessons, an autistic child can get the first impressions that he is working together with everyone, and understand that his actions have a real result. This is very important to him. Considering the clumsiness of such a child’s hands, we must select tasks for him so that he feels accomplished in them, so that the work is not particularly difficult, and the effect is bright. A special problem can be the impulsive actions of such a child, the destruction of the result of his work - a sudden desire to tear the product, but after a second the child usually bitterly regrets what he did. To prevent this from happening, the teacher should, after finishing work, take the craft, put it in a safe place - on a shelf, hang it on the wall, but so that everyone can see it, and rejoice with the child in his success.

Almost all children need to say the sequence of their actions out loud. Teach children to speak quietly, in an undertone, and whisper with their lips so as not to disturb others. But do not forbid children to speak out loud - through external speech, meaningful learning of new and difficult material occurs.

It is necessary to take into account that when we teach an autistic child something, we must immediately, without intermediate stages, give him a ready-to-use model: go to reading through practicing the global recognition of simple words, to writing through immediately mastering the spelling of entire letters and words; teach arithmetic, starting immediately with the simplest counting operations. Knowledge of the algorithm is a strength of autistic children. You need to learn it once and correctly. One algorithm for middle and older age. You can't retrain!

Let's consider an algorithm for solving problems in physics:

1. Read the problem carefully.
2. Write down all the data in “Given” and write down the desired value correctly.
3. Convert units to SI if necessary.
4. Make a drawing or diagram if necessary.
5. Write the formula or law by which the desired quantity is found.
6. Write down additional formulas if necessary. Do the math conversions.
7. Substitute the numbers into the final formula. Calculate the answer. Analyze it.
8. Write down the answer.
9. Praise yourself.

Children are offered the following plan for describing a physical quantity.

1. What phenomenon or property of bodies is characterized by this quantity.

2. Define quantity.

3. Name the defining formula (for a derived quantity - a formula expressing the relationship of a given quantity with others).

4. Determine whether this quantity is scalar or vector.

5. Name the unit of measurement for this quantity.

6. Write down the designation of the quantity.

7. Determine the direction of the quantity.

8. Determine how to measure a quantity.

Communication and socialization skills are perfectly formed through the organization of pair work, work in micro groups, role-playing games, duty in the classroom and around the school, with the teacher’s focused work in these areas.

Encourage children to communicate with each other as often as possible, so they can learn proper behavior in society. Classes should also help autistic children identify the emotions of other children, as well as their own emotions. In the teaching process, short stories can be used to describe certain situations and teach autistic children how to behave in certain situations.

Children love fairy tales. Using the plot of exciting adventures, we come up with fairy tales on physical topics. Some children themselves enjoy composing fairy tales according to a given algorithm. Physics comes to life.

By solving tasks, children transfer knowledge to life situations, which is very important for everyone, but especially for autistic children. If a child works in a group, this helps him identify the emotions of other children and teaches him to empathize. So you can offer children a task:

The girl approached the river, got into the boat and the water carried her along.

Help Gerda swim to the shore.

You can also give a task on behalf of the river. This work is organized in pairs. What is not supported by clarity or practical action is not remembered by the child.

The Chinese principle is very suitable for teaching children with autism spectrum disorders: “I hear and I forget, I see and I remember, I do and I understand.”

All educational material must be supported visually; for this you need to use as many pictures as possible, visual reference signals that help autistic children focus on relevant information.

For example, INCH -2.54 cm. Visually it is necessary to show a fragment of the ruler, where it is noted that one inch is equal to two and a half centimeters.

And then you can offer the following task: listen to an excerpt from a fairy tale and determine the girl’s height.

“The girl was very small, no more than an inch. That’s why they called her Thumbelina.”

It is necessary to use both work with devices, and Internet lessons on the main subjects of the school curriculum, and your presentations.

Symbols can be used to visualize abstract concepts. During the lesson, together with the child, we write symbols with colored pencils. Using these cards, we solve problems according to the algorithm, teach how to work with a test to consolidate new material.

When consolidating the material, answering test questions, the child again turns to these cards.

The child completes his homework using reference notes.

We don’t start asking until we have explained, taught, or given a sample.

Autistic children often don't have very good handwriting. For children with motor difficulties and written language difficulties, it is advisable to provide the opportunity for oral communication. In cases where it is difficult for a child to answer in front of the whole class or due to the peculiarity of pronunciation, you can offer to do written work, a test, or a written message.

At the moment, there are a large number of special teaching aids adapted to correct various learning difficulties. To correct writing, it is recommended to use special pen attachments, stencils and stops. When performing laboratory work, you can use printed publications or printouts of completed laboratory work.

When performing individual tasks, the skills of understanding the physical meaning of a quantity and transferring knowledge to life situations are developed. Children need to ask the question: why?

Students can be given individual tasks that require them to complete a phrase.

1. A physical quantity equal to the ratio of the force acting perpendicular to a surface to the area of this surface is called...

2. To reduce the pressure on the soil in cars, tractors, combines they do...

3. To reduce the force when cutting, you need... pressure, for this you need... the area of the blade, i.e. .. To help a person falling through the ice, you need to crawl towards him in order to... put pressure on the ice.

4. The size of a soap bubble under the pressure of air blown into it increases equally in all directions, as a result of which the bubble takes the shape of a ball. This phenomenon confirms the law...

5. Fluid pressure is at the same level at all points...

Homework should be aimed at eliminating gaps in previous program material, additional elaboration of complex topics, and the formation of individual compensatory mechanisms. It is important to understand exactly “what homework you are giving and why” to this particular child.

When organizing the educational process, it is necessary to remember that we teach only what is necessary to master the program in the future.

Even a formally intellectually normal autistic child must specially learn what ordinary and even most mentally retarded children are given “for free.”

In all tests assessing mental development, an autistic child shows the worst results precisely in tasks assessing his understanding of social meanings, because they live in isolation and do not participate in common life. Such children really find it difficult to understand the simplest meanings of life. Even after acquiring knowledge and mastering skills, one will never have the opportunity to use them practically. One mother who actively taught her child and successfully completed the program with him formulated this very accurately and sadly. She said: “My son has learned everything that is necessary in the program, he will answer the examiner’s questions correctly, but it seems to me that we have put this knowledge in some kind of bag from which he will never get it out himself.” Regardless of the level of their mental development, autistic children do not begin to practically use their achievements without special work.

For this, a detailed emotional comment from an adult is very important. The teacher should be somewhat like an oriental singer who sings about what he sees, what he is experiencing now. At the same time, the commentary should also contain information about the adult’s own experiences, his assessments, worries, doubts, difficulties of choice, which make it possible to introduce the child into the inner world of another person. It is often useful to create a special general concern, a focus on helping someone else, perhaps a fellow practitioner, who needs it.

In technology lessons, the issue of “Family Budget” is discussed.

- How can you save your family money?

Taking tests is difficult for children due to the very structure of the organization of tasks. The greatest difficulty is choosing the correct answer. , since very often it is easier for a child to answer a question himself than to determine which of what is written is correct and which opinion is wrong.

The greatest difficulty is not the test itself, but filling out the assessment forms. We think it is possible to provide assistance at this stage. In some cases, providing unlimited time to complete work improves its quality. There are situations in which, in order to achieve optimal results, it is necessary to provide the opportunity to perform work at home or individually at a specially allotted time. It is also recommended to give the child the opportunity to redo the work.

When working with text, it is important to highlight keywords.

The main rule for a teacher is that the child should be successful not so much in learning, but in the sphere of communication and interaction between all participants in the educational process: teachers, children, parents.

An excursion as a living, direct form of communication develops emotional responsiveness and lays the foundations of moral character. Excursions are the most effective means of comprehensive influence on the formation of a child’s personality

In order to arrive at a more objective final mark, it is necessary to evaluate the child’s work daily so that a single mark on the final test does not become decisive.

1. While explaining the task, highlight in the textbook those tasks that will need to be done.

2. After the instructions, look at each student.

3. Make sure everyone understands the task correctly and is ready to complete it.

4. Repeat the instructions individually.

5. If the child does not begin to complete the task even after repeating the instructions, try doing the task with him at the board.

6. The next time you present a similar task, involve a tutor in the work.

7. When completing tasks independently, do not miss

the sight of the other students.

Let's define ways to overcome the specific characteristics of a child with autism:

Convey information through diagrams, visual pictures,

Avoid overwork

Clearly organize the learning space,

Use signed storage systems,

Label items the child uses

Address the child by name,

Teach self-care and household orientation skills,

Master the activity in parts, stages, then combine it into a whole,

Use reinforcement for correct action with tasty rewards, hugs, incentives,

Constantly develop gross and fine motor skills.

Related information.

— Does the neurodiversity paradigm contradict the idea that autistic children need to be taught something? After all, training suppresses their individuality.
This question was asked to me by a woman who works with autistic children. This question continues to surprise me, even though I have heard it more than once. Perhaps he surprises me because the answer has always been obvious to me:
- Of course not. After all, if a child is not taught household skills, he will never be able to live independently. If a child is not taught to speak or use alternative communication, he will be completely helpless because he will be deprived of communication with the outside world. If you do not teach a child to read, write, arithmetic and various sciences, then illiteracy and lack of education can greatly affect the quality of his life in the future.

The neurodiversity paradigm is based on the fact that there is no one correct way of functioning of the brain and nervous system, and that not all deviations from the average and generally accepted norm are pathological. The neurodiversity paradigm speaks of equality for autistic people. Equality for autistic people does not mean that autistic people should be helpless, that they should have no connection with the outside world, that they should not be able to live independently, and that they should have a lower quality of life than non-autistic people. So the neurodiversity paradigm is more likely contradicts the idea that autistic children do not need to be taught anything, or that one must very quickly give up trying to teach something to an autistic child.

The problem is not with the neurodiversity paradigm, but with the fact that when teaching an autistic child, many parents, teachers and professionals try to suppress his personality. And this approach is used so often that in the minds of teachers and specialists, one has become inseparable from the other. How and why does this happen?
Why have I never heard the mother of an ordinary neurotypical girl afraid to teach her daughter to tie her shoelaces, speak or read because it could allegedly deprive her of her individuality?

When a mother teaches her neurotypical child to speak, read, or tie shoelaces, and if the child does not master these skills quickly, the mother begins to use special teaching methods.
When a mother tries to teach exactly the same skills to her autistic child, and he does not master them right away, then in order to teach him, the mother turns to a psychiatrist or therapist and uses therapy.

Therapy, in contrast to teaching methods, assumes that there is some extremely undesirable deviation from the norm, some kind of disease that needs to be cured.
So what kind of disease do doctors want to cure if a child cannot learn to speak or tie his shoelaces? No matter how absurd it may sound, if a child is autistic, then that “disease” turns out to be autism.
Very often, teaching a child necessary or highly desirable skills for life, the same ones that are taught to neurotypical children, is called “autism therapy.”

Obviously, having learned these skills, the child will not cease to be autistic. There is a myth that autistic children's brains become less "autistic" after they are trained through "therapy." Of course, this is not true. If I teach you to shake your hands and arrange objects in a row, it won't make your neurotypical brain autistic. Another thing is that the brain “evolves”, and in adults it works differently than in children. This extends to autistic people as well, so that over time many children actually become “less autistic” if we consider the functioning of an autistic child’s brain to be the norm for autism. Then what does “autism therapy” change and on what basis can autistic children experience it?

Autism “therapy” can affect a child's behavior, making that behavior less autistic. Through therapy, it is possible to teach an autistic child to pretend to be normal, and parents often “purchase” this “pretend training” in a “bundle” with teaching useful skills, such as mastering alternative communication.

Often, teaching an autistic child how to communicate is considered successful only if the autistic child learns to make eye contact like a neurotypical, move like a neurotypical, talk like a neurotypical, in general, if he can pretend to be neurotypical.

During “therapy,” they try to “cure” behavior that is natural for an autistic person, such as stimming, as well as the child’s own desires and aspirations (for example, an autistic child may be forced to give up his “obsessive” interest in dinosaurs or watch his favorite cartoons because they “do not correspond to age"). Therapists have been trained to perceive anything unusual in a child as pathological, even if this unusual thing poses absolutely no danger. This training-therapy is really suppresses individuality child and can provoke in the child distrust of others, self-hatred, perception of his natural needs and peculiarities of his perception as something wrong, depression, suicidal thoughts, inability to choose a favorite activity in the future, because in the past all the aspirations of this child were suppressed by parents and therapists. Even if the child does not hate himself or the significant part of his personality that autism is, it is very likely that such training will cause him serious psychological trauma. If he, despite the fact that all the people around him consider his way of thinking, his interests and his natural behavior as something undesirable, is able to maintain his self-esteem, most likely “training” will have a negative impact on his perception of other people. It can cause severe social phobia, misanthropy in a child, or form in him ideas about autistic superiority and neurotypical people as extremely vile, dangerous and inferior people.

So, the harm of educational therapy based on “rewriting” the child’s personality is clear. Then why do parents of autistic children choose such “therapy” for their children and try to make the autistic child conform to the dominant idea of the norm?

The fact is that most parents of autistic children believe that their child can live a full life only if he can behave like a neurotypical person.
But copying neurotypical behavior is not the only method for autistic people to adapt to the dominant neuronormative culture.
How else can autistic people adapt to life in a society designed for neurotypicals?
Basically, now we are talking about social skills, but what are they?

This question was answered very accurately by Nick Walker, an autistic activist and one of the leading American ideologues of the neurodiversity paradigm: “When teaching autistic children or working with autistic people, the term “social skills” is used, which usually means “the ability to comply with the dominant norms of social interaction in society.” " But leaving, continuing to behave in a natural way, is also a “social skill.” Changing social reality by fighting for the right to be who you are is also a “social skill.”

So, there are three main methods that an autistic person can use to interact with society in general and with their neurotypical acquaintances in particular.
This is a method of self-advocacy - based on these very attempts to change public perceptions of the norm, or at least defend your right to behave in a natural way for yourself, a method of avoiding unfavorable situations, and the method of “adjusting to society”, the same one that experts most often talk about on autism issues.
None of these methods are “more difficult” or “easier” - more often than not, an autistic person has a tendency to engage in certain behaviors and if, for example, you find it easier to pretend to be like the people around you, your child may find it easier and more comfortable to assert their rights.
None of these methods are “better” or “worse” than the other. Preferring one method over another is as normal as the fact that some people prefer to write with their right hand and others with their left.
None of these methods contradict the neurodiversity paradigm.
All these methods need to be developed - one child should learn to defend his rights, another should learn to appear normal, and a third should avoid unfavorable situations.

So, now let's look at these methods in more detail:

1) The method of adjusting to dominant norms or the method of imitation.
This method is just as consistent with the neurodiversity paradigm as the other two. After all, if you copy someone or try to adjust your behavior to someone else’s standards, this does not mean that you recognize his superiority. For example, to be an actor, you don't have to think that the characters you play are better than you. And in order to “adapt” to the client while working with him, the marketing specialist does not have to think about the client’s superiority.

As the autistic guy Arken Iskalkin wrote in his article “I want to be normal”: “Now I no longer believe that I need to become normal, because there is no norm. And I wouldn’t completely break myself either. But to be able to professionally and programmatically recreate the behavior of a neurotypical person when needed is something that an autistic person really needs now, and this is what would be best to focus on. Moreover, this is often necessary to repel the attacks of ableists who, under pressure, impose their dogmas, which destroy the self-esteem of autistic people.”
As you can see, in this case, attuning is simply a convenient tool for interacting with other people and in no way pathologizes the way autistics think or implies that the way autistics think is wrong.

According to statistics autistic girls and women use the tuning method more often than autistic guys. Some autistic girls use this method at an early age, noticing their differences. In order to fit into a group or meet adult norms, they copy the behavior of their neurotypical peers. Neurotypical children often repeat the actions of other children and adults involuntarily, with little or no awareness of it, while autistic girls often consciously copy the behavior of others. This often becomes an obstacle to the correct diagnosis of autism, because the “adjustment” prevents parents of autistic girls from discovering that their daughters have communication problems.

For many autistic people (regardless of gender), conforming to neurotypical norms and copying the behavior of other people is almost impossible, especially in childhood and adolescence. Many autistic people can copy other people's behavior, but this requires too much emotional strength from them. This “life of a scout,” in which it is necessary to constantly play some role and adapt to someone, can cause serious mental problems. This is probably one of the reasons that autistic women are more likely than autistic guys to have co-occurring mental health diagnoses such as clinical depression and obsessive-compulsive disorder. Therefore, if your child cannot copy the behavior of neurotypical people, or if this is difficult for him, do not require this of him under any circumstances.

At the same time, there are many autistic people for whom the method of adjustment and/or copying is the most convenient, simple and safe way to interact in society. If you think that your child may be one of these autistic people, do not interfere with his desire to copy other people and, if possible - depending on the desire and strength of the child himself - develop this skill. However, avoid the temptation to force your child to always copy behavior that is not necessary for him to appear “normal” and make sure that the desire to copy other people is not caused by low self-esteem.
If it really is a matter of self-esteem, then do not forbid your child to copy other people, but do your best to help him develop self-confidence and a positive autistic identity.

2) Method of avoiding unfavorable situations.
Those who choose this method behave in a natural way most of the time, but try to avoid situations in which their strange behavior could harm them.
This method is most often (but not always) chosen by those autistic people who do not have “high goals” associated with working with people. Indeed, not all people want to earn a lot of money, have the most expensive car, become a television star or the president of the country. And that's completely normal. Even if your child dreams of working in a low-paying job where he will receive exactly what he needs in order to provide himself with only the bare necessities, this is normal. I hope you will not deny that happiness is more important than prestige and money.

Perhaps your avoidant child dreams of success, but hopes to achieve success, for example, by using his technical or economic knowledge and communicating with a very limited number of people. And the experience of some scientists from Silicon Valley shows that this is possible.

Also, at certain periods of their lives, autistic people, even those whose life plans are directly related to working with people, use the “avoidance” method in order to avoid stress and emotional burnout. This method may be a necessary refuge and how long this refuge will be needed can only be known by the autistic person.
The avoidance method is not a sign of laziness, weak will, or desertion. It's often a coping mechanism or a handy strategy for saving time and energy that can be spent on simpler, more interesting, and more productive things than dealing with unpleasant and strange people.
Avoiding unnecessary social interaction is not so easy, and it is as much an art as playing the role of another person or adapting to people.

3) Self-advocacy method.
Those who use this method try to be themselves no matter what. They explain to others the peculiarities of their behavior, defend their rights in a situation where they believe that they are being discriminated against because they behaved strangely (for example, when applying for a job). In a broader sense, this method can be called the method of activism, because those who choose it often prefer to change the system than to change themselves. These people are fighting ableism in the broadest sense of the word - from unwitting ableism among their acquaintances, to advocating for the interests of people with disabilities at the state level. The activism of these people can be based both on the neurodiversity paradigm, when they claim the equality of autistic and neurotypical neurotypes, and on the pathology paradigm, when they explain their behavior as a disease and look for a way to “cure” and “prevent” autism.

Unlike those who try to imitate other people, proponents of the “method of activism” try to get other people to accept them exclusively for who they are. Unlike those who prefer to avoid problematic situations, activists often rush into action themselves, for example, taking part in conferences of parents whose views obviously contradict theirs.

It is this way of interacting with society that one most often hears about from supporters of the neurodiversity paradigm, because the vast majority of them are self-advocates or even activists. It is this method, as the simplest and most convenient for myself, that I most often write about.
At the same time, as I wrote above, I do not claim that this method will be the easiest for your child, but such a possibility exists. You may not be aware of this now, just as my parents and the parents of many other autistic self-advocates were not aware of it at the time.
Perhaps, in order to discover their abilities for activism and self-advocacy, the child must have information about the possibilities of using this method and how it works, and perhaps he needs to get rid of related problems or become more self-confident.

Or perhaps self-advocacy and activism are simply not his path.

Conclusion.
So, there are three main ways that autistic people interact with society. Most autistic people find one of these methods easier and more convenient than the other two.
Additionally, the vast majority of autistic adults use all three methods in their daily lives.
For example, I prefer the method of self-advocacy, but when I have little time, when I am tired, I cannot explain to people the reason for my behavior. Sometimes I can't do this simply because it becomes difficult for me to formulate thoughts in words. In such cases, I try to avoid any interaction with other people or at least those situations in which I have to explain to other people what I am doing.
Sometimes, such as during job interviews or important conferences, I try to look people in the eyes to appear more “normal.” Yes, I really advocate changing the system and believe that I do not have to adapt to others. And I don't want to do this. But changes in public consciousness will have to wait a long time, and I need the result now.

What I called “three methods” is a rather arbitrary combination that I made based on my experience, the experience of my autistic friends and the experience of authors of books and articles on the topic of autism. In fact, there are thousands of similar strategies. For example, I combined autistic behavior under favorable circumstances into one method, and avoidance of social interaction under unfavorable circumstances, calling it the “avoidance” method. But an autistic person may behave autistically most of the time, and at the same time use adjustment and imitation in all “unfavorable” and difficult situations. Essentially, each combination is a distinct strategy, and each autistic person has their own unique strategy for interacting with society, which may change over time.

But I did not write this article in order to embrace the immensity and describe all the possible ways autistic people interact with society. I wrote it to make you understand that these ways of interacting are, in fact, tools, and they may or may not contradict the neurodiversity paradigm. They contradict the neurodiversity paradigm only when you try to justify the use of one of the methods as a “flaw” of the autistic neurotype, or when you try to impose on your child a way of interacting with society that is unnatural for him.

The fact that all three methods can be useful in life does not mean that a child should master them all at the same time. Most often this is practically impossible, and too intensive training will lead to the deterioration of existing skills. It is best to inform the child about all three methods and allow him to choose the method that is most convenient for him and help him develop his talents.
Most likely, he will be able to take something from other methods at a later age if he considers it necessary in his life.

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There are many ways to correct the behavior of autistic people, home training programs, and methods based on in-depth knowledge of the earliest stages of child development and the principles of applied behavior analysis. Methods for treating autism and methods for behavioral correction of autism are varied, but the “Play Time” programs by Greenspan and RMO – “Development of Interpersonal Relationships” by Gutstin and Shiley are considered to be among the most effective and give the opportunity to work with an autistic child independently at home. Let's talk about them.

TREATMENT METHODS FOR AUTISM: PLAY TIME PROGRAM

The Floor Time technique was created by Stanley Greenspan. The Play Time program is based on using a child's interests, even pathological ones (for example, spending hours rubbing something on glass), to establish contact with him. Correction of autism in children occurs according to the following principle. The parent or therapist stands nearby and also begins to rub the glass, or closes the glass from the child, then the child is simply forced to react to this somehow: either start rubbing the glass in another place, or rub the parent’s hand, or take turns rubbing the glass with the parent - any of these options is already the beginning of contact.

1. stage of the child’s interest in the world (reached at approximately 3 months of age),
2. attachment stage (by 5 months of age),
3. stage of development of two-way communication (by 9 months of age),
4. stage of self-awareness (by 1.5 years of age),
5. stage of emotional ideas (by the age of 2.5 years),
6. stage of emotional thinking (by 4 years of age).

Autistic children, as a rule, do not go through all stages, but stop at one of them. The goal of the Play Time program is to help the child go through all stages. For example, two-way communication is achieved when the child reacts to the therapist’s actions. Each time such a reaction occurs, one circle of communication is completed. The therapist must strive to ensure that the child closes as many circles as possible during the communication process. And the therapist himself becomes an assistant, an assistant with the child; he needs to ensure that the child leads and the therapist follows him. This is how the child realizes and then asserts himself as an individual. This is exactly what behavior therapy for autistic people does.

In the game, the therapist does not offer new ideas, but develops the ideas that the child offers, and asks questions, pretending not to understand, receiving answers, and encourages the child to explain, and, therefore, analyze game situations. In this way, emotional thinking develops in the child, and behavioral correction of children’s autism occurs. The therapist can intervene in the process and offer some new ideas only if the child stops closing communicative circles and interrupts communication.

Greenspan advises not to interrupt the child under any circumstances, even if he begins to introduce some aggressive motives into the game. If a child speaks out in this way, he learns not to be afraid of himself and his own emotions, learns to play with them and manage them in this way.

Unlike ABA, the “Play Time” program, according to the author, does not necessarily require many hours of training; its methods of treating autism can be freely carried out by parents independently at home. However, ideally, parents should be advised by a supervisor who specializes in this teaching method for childhood autism.

METHODS OF TREATING AUTISM: RMR (DEVELOPMENT OF INTERPERSONAL RELATIONSHIPS)

The essence of the teaching method for childhood autism “Relationship Development Intervention, RDI” is briefly as follows. Authors Gutstin and Shiley argue that a child who develops normally begins to be socially oriented very early, at about three months, finds the main pleasure in communication, and gives preference to being alone. Subsequently, this child’s need for communication grows, he learns to share the emotions of the people around him (first his parents), learns to look into the eyes in order to recognize facial expressions, and simply loves to play with his parents (the simplest games, like “peek-a-boo” or “horned goat”) "). This is about six months.

By about a year, the child already becomes able to find pleasure by independently introducing variations into an already familiar game, learns to look for approval or disapproval on the adult’s face for his actions and adjusts his own behavior in accordance with the expression he sees on the adult’s face. By the age of one and a half years, a child learns to quickly switch, without repeating himself, without getting “stuck” on any one type of activity. By the age of 2-2.5 years, the baby begins to understand and respond to the point of view of another person (when sitting opposite an adult and wanting to show him a picture in a book, he turns it over so that the adult does not see it upside down). At the age of four, he understands that other people can have different feelings and different ideas than he does, and begins to become interested in this. Then he begins to understand friendship and make friends.

This side of the perception of the world around us is impaired for some reason in autistic people. For some reason, at the earliest stages, interest and the ability to share the emotions of those around you are not developed. Then the child simply lives without all this, and everything that ordinary children build on this is also not developed and not perceived. Hence the lack of even eye contact among autistic people, let alone interest in the emotions of others. Hence the child’s pathological love for familiar rituals - he did not have the opportunity to learn to appreciate variations. Hence the obsessions - I haven’t learned how to switch. And, of course, the child does not learn to be interested in the opinions of others, does not know how to communicate and make friends.

And how to treat autism in children, what to do? The authors of the methodology offer methods for behavioral correction of autism, allowing you to go through the entire journey with your child in an accelerated version. First you need to teach him to find pleasure in communication. Then you can learn to read facial expressions, coordinate your own actions with someone else, not get “stuck” on one thing, and so on.

Childhood autism: methods of teaching autistic people according to the RME program

That is, the very first, most important step of this teaching method for childhood autism is to teach the child the need for communication. How to do it? For this purpose, there are a lot of specially developed exercises for the first level of behavioral therapy for autistic people. For a particular child, as a rule, they choose a couple of exercises that suit him, and then do them at a fairly rapid pace.

FIRST LEVEL EXAMPLE. Let's say a child needs to learn to separate emotions, look a person in the face so as not to miss something interesting, learn to perceive others (for starters, adults) as the main source of interesting events. For example, the following exercise is performed with the child using the RMO teaching method for childhood autism: he is led along a sofa (the height should be small - this will sharpen his attention and will ensure safety by securing him), at the end of which his mother, who joyfully picks up the baby in her arms . If the child likes it, then pretty soon he himself begins to run to his mother on the sofa. The mother picks him up and, for example, begins to rock him on the sofa cushion, at the same time counting to three out loud, and on the count of “three” she makes a “plop”, carefully throwing the child onto a pile of pillows laid nearby. If the baby likes this, he will soon begin to look at his mother’s face in anticipation of the “splash” before the count of three. Then he again walks towards her along the sofa, again the mother rocks the baby on the pillow, again “plop”.

When he is already comfortable with these exercises, you can start variations - you need to walk along the sofa, sometimes slowly, sometimes quickly, throw the child with a pillow on a pile of pillows on the count of “four”, not on “three”, and so on.

How and how much should you work with your child?

From time to time you need to check whether the baby really gets pleasure from communicating with his mother or from something else, for example, the child likes to lie on pillows. They check as follows: the mother withdraws from herself for a short time, for example, puts the baby on a rocking pillow and turns away from him. If the baby starts trying to restore contact - starts making some sounds, saying “mom” or “more”, pulling on the sleeve, then everything is in order, and the main goal can be considered achieved. If, instead of trying to somehow resume joint play, he begins to jump on the pillow himself, it means that the child values the pillow, it gives him pleasure, not communication, that is, you still have something to work on.

You need to work with your child in this way every day for two to three hours (if more is even better). It is imperative to do small intervals of ten to twenty minutes, half an hour maximum, so as not to overstrain him psychologically and emotionally - at first his attention will be very difficult to concentrate. This kind of play-based behavioral therapy for autistic people can be carried out by parents and other adults. It would be ideal that from time to time the classes would be supervised by a psychologist who specializes in or is at least familiar with this method of behavioral correction of autism (although in our country it will be quite difficult to find one). The goal of this method of treating autism is for the autistic child to begin to enjoy communicating with people.

Features of correctional treatment of autism according to the RME program

There are three important nuances of this teaching method for childhood autism:

FEATURE ONE: Unlike the ABA applied behavior analysis program, no external rewards are used here, such as candy, toys, TV for success, etc. The reward for the child should be the very process of playing together and communicating together, and if this does not happen, adults should think carefully about what and how to change in their strategy.

FEATURE TWO: When playing with a child, no complex toys are used, no board games, or anything at all that could provoke the child to withdraw, on which he could become fixated. This is important, since the goal is to develop his interest in communication, so we cannot allow the already overdeveloped interest in interacting with various objects, rather than the people around him, to worsen. This means that the props for games must certainly be the simplest, most primitive. For example, balls, shapeless soft pillows without inscriptions or drawings (these can be used in a variety of ways - falling on them, building fortresses from them, hiding objects under them, throwing them, etc.), a blanket for playing hide and seek. The same applies to the room itself for activities with a child at this level; it should be as simple as possible, without distractions - a minimum of furniture, bare walls - ideal. If such a room does not exist, you can cover everything with sheets during classes, everything that could distract - a TV, open or glazed shelves and cabinets. Even windows through which the street is visible are recommended to be covered with curtains.

FEATURE THREE: At the two initial levels of training (until the baby masters some important things: attention to facial expressions, rapid switching of attention and some others), only an autistic child and one, maximum two adults should participate in classes. Now, at this stage, he is not yet ready to interact with other children, their spontaneous reactions are still unclear to him, they can frighten him or confuse him. Of course, communication with other children outside of classes should preferably be intense, you just need to remember that the baby is not yet able to derive all the benefits from this communication, but the fact that he will not be embarrassed and frightened by the presence of children is already good.

At the end of the second level, classes with the child can be transformed by starting to conduct them together with other children, but preferably not peers. It is better if these are either younger children or also autistic people who have completed two levels of education, that is, the corresponding level of development. An ordinary child of the same age, sensing the inability of an autistic child to respond adequately to situations that arise in the process, usually takes all control into his own hands, depriving the autistic child of the opportunity to learn to recognize a situation and come up with an adequate solution to it. When two autistic people communicate and have learned to find interest in communication and to some extent coordinate their actions with the reaction of another play partner, then they quite effectively learn to jointly support the game and resolve problems that arise. At the same time, the adult should interfere as little as possible - only if he is asked, or the situation is obviously dead-end (children ignore each other, do not communicate and do not notice).

Levels of interpersonal relationships

In total, according to this method of treating autism, in its development a child passes through six fundamental levels of interpersonal relationships. It all starts with showing more interest in the people around you than in some inanimate objects, and ends with the ability to make friendly relationships and the ability to maintain normal relationships in a group.

Typically, developing children reach the sixth level by the age of four, while autistic children, as a rule, are not at all “understood” above the fourth level (a level that an ordinary child successfully reaches at the age of 1.5-2.5). The vast majority of children with autism spectrum disorders, regardless of age and even possible achievements in various areas (talents for music, developed speech, outstanding abilities in mathematics, drawing, computers, etc.), in terms of interpersonal relationships are somewhere at the first level, that is, at the level of a six-month-old baby. Classes using this method for several months (years) allow the child to rise to the second level and advance further if regular classes are continued.

The goals that are set and achieved at the following levels look something like this:

LEVEL THREE: The child, along with his partner, introduces his own variations into the game, comes up with new rules for it, while coordinating his actions with the actions of his playing partner, and does not insist on necessarily accepting his own rules. In the process, one game smoothly transitions into another game, and what is of interest is not the game as such, but the process of joint creativity, joint creation.

LEVEL FOUR: The child compares his own perception of objects with the perception of their partner (“I think this cloud looks like a hare, what do you think?”), he begins to be actively interested in the emotions of his communication partner.

LEVEL FIFTH: The child compares ideas, emotions and opinions, learns to understand how people really feel, and when they pretend, begins to understand emotions.

LEVEL SIX: Begins to make decisions about what should be done so that a friend can communicate well with him, check what each other thinks about their friendship - doubt, weigh and decide. The child begins to perceive belonging to the group as a valuable part of his own “I” and takes adequate actions to be in the group.

These levels also have their own exercises and diagnostic criteria. In fact, these methods of behavioral correction of autism are applicable to children suffering from almost any degree of illness within the autism spectrum - low-functioning autism, high-functioning autism, pervasive developmental disorder and Asperger's syndrome. Progress does not depend on the starting level of functioning - sometimes, low-functioning children can move forward by leaps and bounds, compensating for their poorly developed speech with sincere interest in people, attention to what is happening and a true willingness to be happy, sad, and empathize with everyone. Of course, these are not exactly ordinary children, but even if only a few words are used appropriately, they allow them to communicate normally with ordinary children in many situations (for example, such as “come on”, “don’t”, “that’s great” and “more”). . Also, scientists have noticed that after the need for communication awakens in a child, speech development occurs much more successfully and faster than before. When a child has a need to explain his desire to another (for example, he wants other children to play ball with him), then the way to do this (the ability to say “come on”, connecting it with the word “ball”) will come much easier and more natural.

The ultimate goal of behavioral therapy for autism is to give children the most fulfilling life possible. What this most fulfilling life is, everyone understands in their own way, but for most healthy and not so healthy people, life becomes fulfilling with the presence of work and friends in it. The ability to have friends among autistic people is more affected - that's a fact. According to a study conducted in the United States, 96% of high-functioning autistic adults have no friends, and 86% do not communicate with anyone other than their relatives. As for the availability of work for autistic people, many of them have, sometimes even outstanding abilities in some area, but the inability to communicate, the inability to communicate normally, sharply limits the opportunities to get a job, and most importantly, to keep it. According to a survey conducted in England, over 50% of autistic adults with Asperger's syndrome have completed higher education, but only 12% have a full-time job. The same survey of high-functioning autistic people in America showed that only 10% have a normal job with a sufficient level of education.

However, it is completely wrong to think that autistic people don’t care or don’t notice this. All the same studies show that about 40% of people with autism become depressed from living in isolation; autistic people themselves testify that they have a hard time experiencing loneliness and the inability to understand what motivates the people around them.

_________________________

The main value of almost any correctional behavioral technique is that they can improve the situation, reduce isolation: teach an autistic person to understand how and why people communicate, provide an opportunity for the autistic person to communicate with other people. And this can be achieved.

“The principle of helping children with learning difficulties is simple: find out what the child is good at and use those strengths to overcome their weaknesses,” psychiatry professor Stephen Camarata writes in his book. “I can honestly say that I have never met a patient who could not be taught.” The main thing is to proceed from the individual characteristics of the child.” Why is simply a diagnosis not enough to educate a child with special needs, and what questions should parents ask specialists?

Most often, educational “problems” are caused by an educational system that uses a one-size-fits-all approach to learning: it lacks flexibility. Parents need to look for doctors and teachers who enjoy teaching children and who are willing to find solutions to problems for children with special needs, rather than trying to fit a rectangular block into a round hole. The specialist must find not only problems in the child, but also strengths. And on the list of what the child does not know how to do, he must name at least one thing that his ward does well.

Learning difficulties? Checking your health

First of all, we need to find out whether any diseases can influence learning difficulties. Routine physical examination and diagnostic tests (such as neurological examinations) may not reveal the specific cause of the problem. But you still can’t assume by default that everything is fine from a medical point of view. Brain tumors, epilepsy, celiac disease (wheat allergy), and traumatic brain injury are just a few of the diagnoses that surfaced when I referred my patients with learning disabilities to the pediatrician.

Several years ago, I worked with a patient in New York City who had been diagnosed with autism spectrum disorder (ASD) by another physician. I insisted that the boy be taken to the family doctor, who ordered a neurological examination. Shortly after this, the child's mother called me and thanked me for saving his life! It turned out that the symptoms of ASD were caused by a brain tumor, and if it had not been discovered then, it would soon have been too late to be treated.

To conduct a comprehensive examination, you should first visit your pediatrician to make sure that learning problems are not caused by any medical condition. And then schedule a visit to a psychologist or development specialist. These may include speech therapists and special education teachers who specialize, for example, in teaching reading. When a child has difficulty with fine motor skills (say, writing), occupational therapists are often brought in.

ADHD, ASD in children and learning difficulties: tests

Be sure to discuss any concerns you have with the specialist who will be examining your child. Ask what tests the child will be given and what learning problems will be assessed. Unfortunately, quite often tests are given only to “confirm” the expected result. Many parents tell how doctors tried to find ASD or ADHD in their children and did not even consider alternative options. After the test confirmed the diagnosis, the child was immediately sent to a ready-made correctional program. Please be careful when choosing places and specialists who will assess your child's condition!

A series of tests must necessarily include an assessment of the child’s nonverbal cognitive abilities, because tests with complex verbal instructions may underestimate a child's actual learning abilities. The test battery should include tasks assessing auditory perception and vocabulary, as well as cognitive skills. The child must also be given tests in reading, writing and mathematics. Finally, the child must be tested using medical tests. For example, there is the Diagnostic Observation Scale (ADOS-2), which evaluates a child for symptoms of ASD, ADHD, and learning disabilities.

All data—cognitive abilities, achievements, and barriers to medical learning—can then be used to develop an appropriate training plan. Testing should never be designed to confirm a presumptive diagnosis such as ASD, ADHD, or learning disabilities. The main thing is to find a specialist who will not put the same label on all children.

For example, if a child starts speaking late, this may be a symptom of diseases such as autism, mental retardation, hearing loss, speech impairment, etc. Many years ago, local pediatricians referred late-talking children to me for evaluation. The doctors were surprised that I gave different diagnoses to patients and gave individual recommendations. I found some children had speech disorders, others had difficulty understanding, others had autism, others had mental retardation, and so on. And the specialists to whom these doctors previously referred children gave everyone the same diagnosis and prescribed the same treatment, even if the symptoms were different.

What should parents do? The simplest answer is to ask the experts: “What will you test? What types of tests will you use? If a child does not understand what is being said, how will this affect the test results? Ask to tell what diagnoses this center makes and what percentage of children in this center or clinic receive such diagnoses? You can also ask what types of treatments they recommend.

Your doctor should give you a written report that includes all test results and recommendations. The doctor should be willing to discuss the reasons for the diagnosis with you. If it is ASD or ADHD, for example, the doctor should explain what behaviors and characteristics were identified and what the tests showed. He should encourage parents to ask questions and treat them with respect, even if they disagree with the diagnosis.

When I had to tell parents that their child had a mental retardation, many disagreed. They began to list everything that their child knew and could do, and I never tried to contradict them or downplay the significance of their words. Instead of trying to convince them that I was right, I answered their questions and explained how and why I came to this conclusion.

If they still did not agree, I did not insist, but switched to areas where the parents saw problems in the child - for example, with speech. I suggested: “Let’s teach your child to speak and understand, because you don’t deny that he needs help with this.”

Treating Autism and ADHD: What You Want to Teach

Having made a differential diagnosis and explained to the parents the reasons for its diagnosis, the doctor will proceed to discuss the treatment program. Here again parents should ask questions. In general, treatment should be aimed directly at improving weaknesses and allowing the child to learn compensation strategies.

Several years ago, I worked with a family whose autistic child was terrified of the noise of the air conditioner. It reacted so violently that it literally punched holes in the drywall walls when the air conditioner was turned on.

I recorded the sound of the air conditioner on a voice recorder and gradually reduced the child's sensitivity. To do this, I slowly turned on the sound while the child was engaged in one of his favorite activities - video games. He tolerated the quiet noise of the air conditioner easily. Over the course of several weeks, I gradually increased the volume until it reached the actual volume of the noise the air conditioner makes. By this time, the child's sensitivity had decreased; these sounds no longer bothered him.

Together with my clinical colleagues, I taught this child to speak, but it seems that the parents were much more grateful that they could now turn on the air conditioning during the hot summer months! Scientific research shows that this type of desensitization can be effective because it targets a specific area. Likewise, parents need to determine exactly what they want to teach their child. And then he must be taught exactly this.

Drug treatment, pros and cons

If a training professional pushes you to take medication for ADHD, ask him if he really wants to improve your child's behavior and if he has tried alternative strategies. I have worked with many children with ADHD and gotten them to reduce their movements, increase their attention, and generally control their behavior without medication. I am not against medications - but only when their use is justified. Thus, an analysis of school programs where children were taught, for example, to sit quietly for a long time, listen carefully in class, write down assignments, do homework, and so on, showed that attention increased, and the number of movements decreased.

If you do agree to drug treatment, be sure to discuss the side effects with your doctor. Never agree to treatment without detailed explanations! Parents also have the right to know what the expected results of treatment are and how long it will take to achieve those results. Ask your doctor the following questions: How will I know if the treatment is helping? If treatment doesn't work, what other options can we try? Will we be able to stop taking medications in the future?

The physician should treat the child's parents as partners and not as obstacles or enemies. He should invite them to participate in treatment in any way possible. Some parents cannot be mentors for their children, study with them, and there is nothing wrong with that. Parents should not feel guilty if they cannot provide treatment for their child at home. But they should definitely be offered the opportunity to participate in treatment.

In any case, the doctor, mentor or teacher must inform parents about the child’s goals, activities and progress. He should support them in trying to run home programs to the extent that they can. Numerous scientific studies confirm that activities with parents have a great effect on children with learning problems.

Learning difficulties: what parents should do

If your child is struggling in class or a teacher suggests they have ADHD or another learning problem, it's important to investigate. Determine whether your child truly has ADHD, ASD, or another learning problem—or whether it is due to a discrepancy between the level and the universal learning style in today's schools. Find out if you can solve the problem by simply changing teachers, classes, or schools. Many of my patients have “cured” their ADHD simply by changing to a more appropriate program.
If a child has been prescribed a pedagogical or psychological examination, parents should insist on a differential diagnosis. The assessment should explain why the child has a learning problem, not determine whether the child qualifies for programs for children with ASD or ADHD.
The examination should identify not only weaknesses, but also strengths in order to develop an individual training plan.
The correction program should be aimed directly at the problem. It should not be typical or indirect. Treatment must be individualized and matched to the strengths and weaknesses of a particular child - then it will be effective.
And finally, don't turn your studies into an endless race. Don't lose sight of what's important to your child. Parents who raise children intuitively value not only their academic achievements, but also their positive relationships.

Comment on the article "Difficulties in children's learning: autism, ADHD, speech disorders. What to do?"

I read to the end only to make sure that there was absolutely nothing useful anywhere.
Too much water, not much use.
More about how cool the doctor works, self-praise, than the necessary information for parents.

28.11.2016 10:36:20, Grape sugar_discussion

Total 2 messages .

Poor development of social skills in autism spectrum disorders

In fact, many parents of children with autism would agree with this view regarding their children's social behavior. They know that their child has many wonderful qualities that they could offer others, but the nature of their disorder, or more specifically, their low level of socialization, often prevents them from making meaningful social contacts. This frustration is compounded when a parent knows that their child desperately wants to be friends with others but is having trouble making friends.

Often their failure is directly caused by ineffective programs and insufficient resources that are available for teaching social skills. For most children, social skills (such as “waiting their turn”, “having a conversation”) are acquired easily and quickly. For children with autism, this process is much more complex. While many children learn these socialization skills simply by participating in social situations, children with autism spectrum disorder often need to be taught them in detail, and as early as possible. This article focuses on the lack of development of social skills in children with autism and describes a five-step model for teaching communication, with particular emphasis on a relatively new and increasingly popular method of assistance - video modeling.

Lack of interest in communication or lack of understanding of what to do

Impaired social functioning is a core feature of autism. Typical deficits in social skills include starting a conversation, responding to other people's invitations to talk, making eye contact, reading other people's nonverbal cues, and seeing things from someone else's point of view. The reasons for the lack of development of such skills can vary from congenital neurological disorders to the inability to acquire these skills (social isolation). Most importantly, underdevelopment of these skills prevents a person from developing and maintaining meaningful and satisfying relationships. Although lack of social skills is central to autism spectrum disorders, many such children do not receive sufficient instruction in these skills (Hume, Bellini, & Pratt, 2005).

This is an alarming situation, especially since the presence of a social disorder can lead to more detrimental problems such as poor school performance, social failure and peer rejection, anxiety, depression and other negative consequences (Bellini, 2006; Tantam, 2000; Welsh, Park, Widaman, & O'Neil, 2001). And having an individual plan for mastering social skills is all the more important when you consider that there are approaches to effectively teaching social skills that can reduce these difficulties.

The long-held belief that children with autism spectrum disorders lack motivation to communicate is often wrong. Many children with autism actually strive to communicate, however, these children often lack the skills to communicate effectively. One young man I worked with is a good example of this. Prior to my visit, the school administration informed me of his inappropriate behavior and his apparent "lack of interest" in interacting with other children. After Zach spent the morning in a separate classroom, he was allowed to eat breakfast with the entire school population (at this time and place that most problem behavior occurs). While he was eating his breakfast, a group of children to his right started talking about frogs. As soon as the conversation began, he immediately noticed it. And I noticed too. While he listened to the other children, he began to take off his shoes and then his socks. I remember thinking, “Oh my god, it’s starting!” As soon as the second sock hit the floor, Zach put his feet up on the table, looked at the group of kids and exclaimed, “Look, webbed feet!” Other children (including me) looked in surprise. In this case, Zach demonstrated a desire to be part of the communication situation, but he apparently lacked the necessary skills to do so in an appropriate and effective way.

This lack of knowing “how to do it” can also lead to social anxiety in some children. Many parents and teachers note that social situations usually cause a lot of fear in their children. The way children with autism describe this anxiety is similar to what many of us feel when we have to speak in public (increased heart rate, noticeable tremors, difficulty concentrating, etc.). Not only does the performance itself cause stress, the very thought of it is enough to create this painful feeling. Imagine what your life would be like if every social interaction you made was as anxiety-inducing as giving a speech in front of a large group of people.

The typical defense for most of us is to reduce stress and anxiety by avoiding stressful situations. For children with autism spectrum disorder, this often results in avoidance of all social situations and, as a result, the development of deficits in social skills. When a child constantly avoids communication, he does not give himself the opportunity to acquire social skills. For some children, these skill deficits lead to negative experiences with peers, peer rejection, isolation, anxiety, depression, substance use, and even suicidal ideation. For others, this creates a pattern of being completely immersed in different hobbies and interests alone, and this pattern is often difficult to change.

Five-speed model

1. Assess social interaction.

2. Distinguish between a lack of mastery of skills and a lack of application.

3. Select intervention strategies.

4. Conduct an intervention.

5. Evaluate and monitor progress.

This paragraph briefly describes my five-step model for teaching social skills (Bellini, 2006). Before you begin providing social skills training, it is important to start with a detailed assessment of your current level. Once the assessment is complete, the next step is to recognize the difference between difficulties in acquiring skills and difficulties in using them. Based on this information, we choose an intervention strategy. Once the intervention begins, it is imperative to evaluate and change the intervention strategy if necessary. Although I use the word “steps,” it is important to note that this model is not completely linear. Thus, in real life, social skills training will not follow a rigid path from stage one to stage five. For example, quite often I notice additional social skills deficits (step one) while I have already begun the intervention process (step four). In addition, I continually evaluate and modify interventions as additional information and data become available.

Assessing Social Interaction

The first step in any social skills training program should be to conduct a full assessment of the child's current level of social interaction. The purpose of this assessment is to answer a simple yet complex question: What prevents a child from forming and maintaining social relationships? For many children, the answer takes the form of a lack of certain social skills. For others, the reason is cruel and ignoring peers. And for others it’s both.

Testing should show in detail both the strengths and weaknesses of the child in terms of his presence in society. The assessment should be a combination of observation (both naturalistic and structured), interviews (with parents, playground teachers, and the child themselves), and standardized measures (behavioral tests and measures of social skills). I have developed the Autism Social Skills Profile, which helps identify typical social skills deficits in children with autism and tracks the child's learning progress. Kathleen Quill (2000) also provides an excellent social skills checklist for parents and teachers in her book Do-See-Listen-Speak. It is important for the team working with the child to determine the current level of interaction and effectively intervene in the area where the child needs help. For example, if testing shows that a child is unable to have simple one-on-one conversations with others, then intervention should begin there rather than with more complex levels of group communication. Or, if the research shows that the child does not know how to symbolically or even functionally use toys, then remediation will likely begin with teaching play skills before teaching social skills. Once a detailed assessment of social interaction is completed, the team must determine whether the skill deficiencies are due to a lack of skill acquisition or skill application.

Distinguishing between lack of mastery of skills and lack of practice in using them

After fully examining a child's level of social interaction and determining the skills we will teach, it is necessary to understand whether underdevelopment of social skills is due to a lack of mastery or a lack of application (Elliott & Gresham, 1991). Simply put, the success of your social skills training program depends on your ability to differentiate between these two things.

Lack of mastery of a skill refers to the absence of a particular skill or behavior. For example, a child with autism may not know how to successfully join in with his or her peers' activities, and so he or she often fails to participate. If we want a child to join his peers, we must teach him to do so.

A lack of skill use implies that the skill or behavior is familiar to the child, but he does not show or use it. In the same example, a child may have the skill of joining, but, for some reason, it does not work out for him. In this case, if we want the child to take part, we do not have to teach him to do it (since he already knows how to do it). Instead, we must work with what is preventing us from using the skill, which may be lack of motivation, anxiety or sensory sensitivity.

A good clue to differentiate between lack of mastery and lack of use of a skill is to ask, “Can the child demonstrate the skill with many people and in many situations?” For example, if a child starts conversations only with his mother at home and does not communicate with peers at school, then this difficulty should be considered as a lack of mastery of the skill. I often hear from school teachers: “The child communicates well with me, so this must be a lack of use of the skill, right?” Not really. In my experience, children with autism communicate more often and better with adults because adults usually make this task easier for them - adults do all the “work” of communication for the child. In baseball terms, just because Tommy can hit the soft, low throws his dad practices with him at home doesn't mean he can hit the balls his peers throw to him on the playground well enough. Sometimes adult communication with a child with autism spectrum disorder resembles these soft, low throws. And although they do this with good intentions, it does not prepare the child for more difficult moments in communication with peers.

Very often, underdevelopment of social skills and unacceptable behavior are justified by a lack of use of skills. This happens because we tend to think that if a child does not demonstrate a behavior, it is due to refusal or lack of motivation. In other words, we think that a child who does not begin socializing with peers can do so, but does not want to (lack of use of the skill). In many cases this is a wrong assumption. In my practice, most cases of social skills deficits in children with autism relate to a lack of these skills.

So if children with autism do not demonstrate some social skills, then most likely it is not because they do not want or refuse to be around other people, but because they simply do not have these skills. If we want young children to be successful communicators, then we must teach them exactly how to communicate. Therefore, it is important to focus on developing the skill.

The benefit of using a skill acquisition deficit/skill performance deficit model is that it helps us select intervention strategies. Most correctional methods are better suited to one or the other. The chosen method of intervention must correspond to the existing deficiency. You don't want to use an intervention program designed for lack of use of a skill if the child's main difficulty is mastering the skill.

In the example above, if Tommy has not mastered the skill of hitting a shot (lack of skill mastery), all the rewards in the world (not even pizza) will help Tommy hit the ball during the game. If we want him to hit shots well, we must further teach him the mechanics of hitting the ball. The same is true for social skills. If we want a child to communicate freely, then we must effectively teach him social skills. Conversely, if Tommy has the skill set but lacks the motivation to “give it his all,” then a cheese and pepperoni pizza might be what helps him perform well on the field.

Once a detailed assessment of social skills has been completed and the team can attribute social difficulties to either deficiencies in skill acquisition or deficiencies in skill use, training can begin. There are many methods that can be used for children with autism. The most important thing is that the strategies used with the child correspond to his personal needs, and that a logical explanation is given for the method used.

Below are examples of techniques that can be used to successfully teach communication skills to children and adolescents with autism spectrum disorder. All of the strategies listed below, except the peer-assisted method, are learning disadvantages. However, some methods (especially the video self-modeling method and the social story method) also work well when there is a lack of skill use. Additionally, it is important to constantly reward the child for his efforts and participation in the learning program.

Selecting Corrective Strategies

Change the child's environment or behavior

In the process of choosing a correction method, it is important to consider the principle of “changing the child’s environment or behavior.” In the context of social skills training, the child's social or physical environment can be changed to provide opportunities for positive social interactions. Examples of this include: training peer helpers to interact with the child during the school day, autism awareness training for classmates, and including the child in various recreational groups such as sports teams or scout troops.

On the other hand, you can change not the environment, but work on the behavior of the child himself. This includes training that allows the child to be more successful in communication. A successful social skills development program must include both changes in the child's environment and work on his behavior. If you only focus on one thing, your efforts may fail.

For example, one family I worked with did an excellent job of organizing peer playdates for their child and ensuring that they attended a variety of leisure activities in groups. However, they were very disappointed that their son was unable to make friends and still had negative experiences with his peers. The problem was that they were putting the cart before the horse. They provided the child with ample opportunities to communicate with others, but did not teach him the skills necessary to be successful in these interactions.

Likewise, teaching a child a skill (behavior change) without changing the environment to make it more autistic-friendly also sets the child up for failure. This occurs when a child with autism enthusiastically tries a new skill in a group of peers who do not accept it. It is important to both teach skills and change the environment. This will ensure that the new skill will be received with understanding by peers.

Methods for teaching social skills

As previously stated, children and adolescents with autism need to be given explicit and detailed instruction in social skills. Traditional methods of teaching social skills (such as board games about friendship and good behavior in the classroom) can be difficult for many children with autism to understand. For example, a school psychologist was frustrated with the little progress she was making with a student with autism. She claimed that the training program was showing positive results for "other children in the group" but that the child with autism "didn't seem to understand it." Of course he didn't understand her! The reason was obvious. A school psychologist was trying to teach students the concept of “friendship.” This is acceptable for other students, but for children with autism these explanations were too abstract. So, instead of spending endless time telling a child about “friendship,” the training should have focused on specific skills that the child could use to make and keep friends. Experience tells me that the concept of "friendship" is much easier to understand when you already have a friend or couple of friends!

There are a number of issues that must be considered when choosing an intervention method. For example, does the training program address the lack of mastery identified in the social interaction assessment? Does the program improve its use? Does the program provide an opportunity to master a skill? Is there research to support its use? If not, how do you plan to evaluate its effectiveness for your child? Is the program appropriate for the child’s developmental level? The following is a list of social skills teaching methods that have been shown to be effective in teaching children with autism.

The next part of the article briefly describes various intervention strategies that have been developed to teach social skills to young children with autism, including peer intervention, thought-feeling exercises, social stories, role-play, and video modeling.

Peer-assisted correction

Using peers as helpers is one good example of effective intervention for young children with autism. Peer intervention is often used to establish positive social interactions among preschool peers (Strain & Odom, 1986; Odom, McConnell, & McEvoy 1992). Peer learning allows us to structure our physical and social environments to create successful moments of social interaction.

In this approach, peers are trained to engage and respond immediately and appropriately to the child with autism's desire to communicate during the school day. Peer helpers must be classmates of the child with autism, have age-appropriate social and play skills, must be attending school full-time, and must have previous experience interacting with children with autism in a positive (or at least neutral) way. Peer helpers should also be taught about the behaviors associated with autism in a polite and age-appropriate manner.

The use of such helpers allows teachers and other adults to act as facilitators rather than active conversationalists and play partners. Therefore, instead of becoming the third wheel in communication between two children, the teacher helps peers start a conversation or respond appropriately to the child with autism and steps aside. Involving peers in interaction also helps to generalize new skills and practice them in a natural environment.

Lessons about thoughts and feelings

Recognizing and understanding thoughts and feelings, both their own and others', is often the Achilles heel of children with autism, but is essential for successful communication. For example, we constantly change our behavior according to the nonverbal feedback we receive from other people. We can continue the story if the other person smiles, looks expectantly, or shows other signs of genuine interest. On the other hand, if a person constantly looks at his watch, sighs, looks in the other direction, we will probably shorten our story (I said “probably”!). Children with autism often have difficulty recognizing and understanding these nonverbal cues. This makes it more difficult for them to modify their behavior to meet the emotional and mental needs of others.

The simplest activity about thoughts and feelings involves showing your child pictures of different expressions of emotion. Pictures can range from the most basic, such as happy, sad, angry or scared, to more complex emotions such as embarrassed, ashamed, nervous or incredulous. Start by asking your child to point to an emotion (“show me where happy is”), then ask the child to identify what the character is feeling (“what is he feeling?”).

Many of the young children I work with have a fairly easy time learning to identify emotions. Once they're good at this, it's time to move on to more complex teaching methods, such as teaching the meaning of an emotion or "why?" this emotion appears. To do this, the child needs to draw conclusions based on the context and signs shown in the picture. So, based on the information in the picture, you might ask, “Why is the child sad?” Pictures should depict characters participating in different social situations and showing different facial expressions or other nonverbal ways of expressing emotions. You can cut out pictures from magazines or download and print them from the Internet. You can also use illustrations from children's books, which are usually rich in emotional content and situational images.

Once your child is doing well with pictures, move on to television programs and videos of social situations. Many programs shown on television are excellent sources of teaching material because they show characters in social situations who clearly express their emotions. You can use the same mechanism as with pictures, but this time the child will make inferences based on dynamic social cues. Simply ask your child to identify how the characters on screen are feeling and why they feel that way. When the action is too fast for your child, pause and ask a question about the still picture (make sure your TV is showing a clear picture when paused).

Social stories

The social story method is often used to teach social skills to children with disabilities. Social stories are a gentle way to explain social concepts and rules to children in the form of a short story. This strategy can be used to teach a range of social and behavioral concepts, such as crossing the street, playing a game, and going into the countryside.

Carol Gray (1995; 2000) outlines the components that are necessary for a successful social story: the story must be written in response to the child's specific needs, the child must want to read the story himself (depending on his level of ability), the story must match the abilities and level of understanding of the child, the story should contain less demonstrative “can” or “could” instead of “will” and “should”.

This last component is especially important for children who tend to refuse to follow adult instructions (that is, a child who does not decide what to do until you tell him to do something... and he will do exactly the opposite!). The social story can be illustrated with pictures or played on the computer to tap into the child's visual thinking or interest in the computer.

I have found that children with autism learn best when social stories are used in conjunction with role-playing games as a “text book.” Thus, after reading a social story, the child practices the skill presented in the story. For example, immediately after reading a story about playing with peers, the child will try this skill in the form of role-play. Then, after reading the story and practicing, the child will be involved in a social situation where he will have the opportunity to use this skill in a natural setting.

Role Play/Behavioral Rehearsal

Role-playing and behavioral rehearsals are used primarily to teach basic communication skills. It is an effective approach to teaching social skills and allows for positive practice of these skills (Gresham, 2002). Role play involves acting out situations or activities in a structured environment to try out newly acquired skills and strategies, or previously acquired skills that the child has difficulty using. Role-playing games can follow a script or be spontaneous. In the second case, a situation is described to the child (for example, asking another child to play with him), but a specific scenario is not given. I usually combine pre-written and unscripted elements in each role-playing game. For example, the child may be given a question or the first sentence, but the rest of the conversation should be spontaneous.

I use role-playing games to teach children many communication skills, especially those that involve starting a conversation, responding, and ending a conversation. In one scenario, the child must start a conversation with a peer who is busy with something. Consequently, he will have to ask permission to join or involve the interlocutor in his own game. The latter is usually the most difficult for children with autism.

During the first learning sessions, it is common for a child to become stuck in conversations and interactions for several minutes, not knowing what to say or how to proceed. At an early stage, the child must be given enough time to understand and respond to the role-play scenario. As you practice, your speed and confidence will increase.

Video modeling and video self-modeling

Video modeling is, without a doubt, one of the most effective strategies for teaching social skills that I have used with autistic children. Video modeling involves watching a video demonstrate a behavior and then repeating the behavior of the model. Video modeling can involve peers, adults, or the child himself (video self-modeling). The benefit of video self-modeling is that it provides the child with visual evidence of success... their own success! Video self-modeling can be used to master skills, improve skill use, and reduce problem behavior. It combines a powerful teaching tool for a child with autism (visual instruction) with an effective intervention method (modeling).

A growing body of research promises great success in the use of video modeling (with a peer or adult as a model) and video self-modeling as a therapeutic approach for children with autism. Bellini and Akullian (book in press) reviewed studies of video modeling and video self-modeling, including 20 papers by their colleagues and involving 63 children with autism. Results confirm that video modeling and video self-modeling are effective interventions for social communication skills, challenging behaviors, and functional skills in children and adolescents with autism. In particular, these methods provide an opportunity for skill acquisition, and these skills acquired through video modeling and video self-modeling are maintained over time and transferred to other people and situations. Thus, this approach can be considered effective for children with ASD from early childhood through adolescence. Studies have demonstrated dramatic increases (or decreases) in selected behaviors over an average intervention duration of nine video clips. However, the average length of the videos shown to participants was only three minutes.

Video self-modeling generally falls into two categories: creating a positive self-image and modeling video behavior (Dowrick, 1999).

Creating a positive self-image allows children to observe behaviors that are already in their behavioral repertoire. Creating a positive self-image can be used for behaviors that are very infrequent or that the child has stopped using. An example of positive self-image intervention for preschoolers would be to record a video of the child participating in something with peers (if this happens rarely) and then show the video to the child. Buggy and colleagues (1999) used this method to increase responding in young children with autism. The children in the study watched videos of themselves answering questions while playing. Although these children rarely answered the questions, the video recordings were edited to show that the children answered freely (moments where answers were missing were removed from the recordings). This intervention dramatically increased the number of verbal responses children made without prompting.

Video shaping, another category of video self-modeling, is typically used when a child already has the necessary skills in their repertoire but is unable to combine them to complete the activity. For example, a child can get out of bed, brush his teeth, get dressed and comb his hair (morning routines), but cannot perform these actions in the required sequence and without prompting. With this correction method, we will record on video how the child performs each procedure, and then put the fragments in the required sequence. The same can be done with ordinary social communication sequences. For example, you might record the child doing the following three things: starting a conversation, responding to another child, and ending the conversation in an acceptable way. The three scenes can then be combined together to create one successful free conversation.

Video modeling is also useful for children who need extra help or encouragement to successfully complete a task. Taking into account “hidden support” is an important component in correction using behavior shaping on video. For example, you can record how a child interacts with peers while an adult helps him with gestures and prompts. The adult's cues will be cut out (hidden) so that when the child watches the video, they will see themselves being independent and successful. Behavioral modeling via video requires additional technical capabilities compared to the method of creating a positive self-image, but it usually requires less “raw” video material.

Carrying out the intervention

Once you have assessed social functioning and selected the skills to teach, differentiated between deficits in skill acquisition and deficits in skill use, and selected an intervention, it is time to begin making interventions. Social skills training should take place in different places (home, classroom, resource class, playground, around other people, etc.) and by different instructors. There is no “best” place to teach social skills, although it is important to keep in mind that the goal of any socialization training is to enable the child to be socially successful with their PEERS in a NATURAL environment. Essentially, if a child is being taught social skills in a school resource class (or with the help of a private therapist), there needs to be a plan in place to transfer those skills from the resource class to the natural environment. Parents and teachers should look for opportunities to support and encourage the skills being taught to the child in the resource class or remedial center.
The level of development of the skill depends on the individual child. Some children will begin to use a skill after just two or three lessons, while other children will take three months before they begin to “get the hang of” the material and begin to use their newly acquired skills. Of course, simply using or trying out a skill is only the first step to social success. The child will need extra time to improve the skills he learns and develops. Gresham et al. (2001) recommend that social skills training be provided more frequently and intensively than regular training. They concluded that "thirty hours spread over 10 to 12 weeks is not sufficient." Social skills training should be intensive (as frequent as possible) and comprehensive (occurring in any environment where the child is).

Evaluation and modification of intervention method

Although “evaluating and modifying intervention” is listed last, it is naturally not the least important. Plus, it shouldn't be the last thing on your mind when designing a social skills training program. Typically, once I understand what specific skill deficiencies need to be addressed, I begin to develop methods for assessing the effectiveness of the correction. In a very basic example, if the goal of correction is to initiate conversation, then I might use data on the frequency of conversations with peers and adults as a basis. I will then continue to collect data on the child's conversational initiative throughout the intervention phase. Careful data collection is essential to assess the effectiveness of an intervention. This allows us to understand whether the child is benefiting from the training and how best to modify the program to best help the child. Within the school, accurate data collection is a mandatory rule. When I work with school teachers, we focus on integrating the social skills curriculum with the child's behavioral and social goals. Thus, the fifth stage is usually an important aspect of development, intervention and integrity.

An example of using the described method

The following example describes a method for teaching social skills to a little girl diagnosed with autism. “Kelly” attended kindergarten and had below average speech ability. Although her vocabulary was average for her age group, she rarely used speech spontaneously with classmates and teachers. She spoke only in response to direct questions and joined the conversation only if others started the conversation. Consequently, Kelly spent most of her time on the playground by herself, rarely interacting with her peers. The social skills assessment concluded that she had significant deficits in the ability to initiate and maintain conversations with peers. Social skills intervention was designed to increase the frequency and duration of conversations with peers. Data on conversations with peers (when she initiated them and when she responded to peers) were collected both on the playground and during breaks.

Two peer helpers were selected to participate with Kelly in the playgroup. Peers were instructed to initiate conversations and respond immediately when Kelly spoke to them. Her peers were also given developmentally appropriate information about autism and Kelly's behavior, which included flapping her arms. Also, prior to starting the playgroup, Kelly was read a social story related to conversation starters. Each time a story was read, Kelly was given the opportunity to practice the skill through role play. Children participated in a playgroup three days a week for two weeks. During the group sessions, Kelly was given prompts to initiate conversations herself and was also prompted to respond promptly and appropriately to her peers when they initiated conversations with her. The sessions were videotaped over a two-week period. The video was then edited to remove all of Kelly's clues and help. The edited videos showed Kelly interacting freely and successfully with her peers. The tapes were shown to Kelly in five-minute chunks over two weeks. For Kelly, video self-modeling led to immediate improvements in making and maintaining connections with peers both during the game and on the court. By the end of the school year, Kelly had made friends with two children, friendships with which continue to this day.

The purpose of this article is not to provide a list of all social skills interventions available to children with autism. Instead, the article presents a social skills training model that assists parents and professionals in socialization training. However, not all programs are suitable for every child. First a huge amount of careful planning must be done to make sure that the methods used in the program meet the child's needs. Therefore, a comprehensive intervention program is needed that addresses the individual characteristics (both strengths and weaknesses) of the child. In the example described above, Kelly was provided with weekly social skills sessions in addition to speech and occupational therapists. Kelly needed a full range of adjustments in order to be socially successful. As her mother told me, Kelly is unlikely to be a party star or a socialite. But after completing an effective social skills training program, Kelly had the opportunity to develop meaningful personal relationships. And we were given the opportunity to meet a wonderful child.

Thanks to Tamara Solomatova for the translation.

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