Wednesday, November 19, 2008

I'm off to SCERTS training

Hello all! I'd like to apologize for the slow addition of new material to my blog. I've been rather busy lately, and there are some exciting developments on the horizon.

Tomorrow I am off to Milwaukee to learn more about the SCERTS program. SCERTS stands for Social Communication, Emotional Regulation, and Transactional Support. It is my understanding that this program is similar to RDI in theory and strategies, but without the strict protocol requirements. It is my hope that the SCERTS model will offer an alternative for families who are unable to afford a full RDI program at this time, but who still want to treat their child's core deficits of autism.

I will be posting more information here next week. Have a wonderful holiday!

Monday, November 10, 2008

Indirect Prompts

In RDI®, the goal is co-regulation, not compliance. Direct prompts foster compliance, and do not teach a child how to think. By using indirect prompts, you are offering your child an opportunity to practice dynamic thinking. It may take a little bit longer to get things done, but in the long run, your child’s cognitive growth will be worth it.

Remember, it’s always better to show than to tell. Use gestures and nonverbal prompts whenever possible. For those moments when you really need to say something, try to word it indirectly. Pair it with a gesture or other nonverbal cue if you’re concerned that your child won’t understand, and make sure you give your child extra processing time.

Direct Prompts
Pick that up.
Come here.
Put this in the box.
Eat your dinner.
Push in your chair.
Put on your coat.
Brush your teeth.
Give me that.
Stop that!

Indirect Prompts
That doesn't belong there.
I need your help.
That goes over there.
Your food is getting cold.
You're too far.
Here is your toothbrush.
It's cold outside.
I like that one.
I don't like it when you do that.

These are just a few examples of ways to “prompt” our children without actually prompting them. Of course, if your child is running into traffic, use a direct prompt and whatever means necessary to keep him or her safe. However, in most situations, it is possible to use indirect prompts. Try to think of ways to re-word other prompts in ways that offer your child opportunities for thinking, rather than blind obedience.

Thursday, November 6, 2008

More Than Words: Broadband Communication

Communication is not always verbal. Think of all the ways you can communicate without ever saying a word - gestures, facial expressions, body language. It is possible to conduct full, back and forth conversations, without ever saying a word.

Also, consider how nonverbal cues can change the meaning of spoken words. A simple phrase, like "Nice shoes," can be taken literally. The person speaking may really like your shoes. However, subtle, or sometimes not-so-subtle nonverbal cues, such as a shift in facial expression, a change of voice tone, a roll of the eyes, can express the exact opposite meaning.

Communication is a mix of spoken words and nonverbal cues that combine to create meaning. It is well documented that individuals on the autism spectrum have difficulty reading nonverbal cues, and that they tend to take spoken words literally. This makes it difficult for them to read subtle social cues that the rest of us notice without having to think about it.

In typical development, nonverbal communication develops prior to speaking. Typically developing babies are experts at nonverbal communication long before they ever speak a word. Parents automatically slow down their movements and exaggerate their facial expressions and gestures when interacting with infants. During the first year of life, babies are interacting with their caregivers, learning what different facial expressions and gestures mean, and learning how to use them in order to communicate.

This cycle breaks down when a child has an autism spectrum disorder. There is a communication feedback loop that goes between parent and child, in which each partner is reading and responding to the cues of the other. When your child is on the autism spectrum, s/he can be overwhelmed by the same amount of stimulation that would be optimal for a typically developing baby. Many children with ASD respond by withdrawing. All babies will send withdrawl signals when they are overstimulated or tired, but children with ASD send them more often, as they become overstimulated more often. Parents feel that they must be doing something wrong, or that their child is rejecting them, when in fact, the child is simply overstimulated.

This is why it is so important to slow down in all of your interactions with your child. This includes verbal as well as non-verbal cues. Previous posts have discussed the importance of using fewer verbalizations, and of giving your child extra time to process your communication. It is also important to slow down and exaggerate your nonverbal cues.

This slowing down and exaggerating your nonverbal cues comes naturally when you are interacting with a baby. It takes more conscious effort with an older child, but the results are worth it. Here are some tips to help your child practice reading nonverbal cues.

1. Choose one nonverbal modality at a time: facial expressions, gestures, prosody, etc. Don't add a new one until your child is comfortable with the one you are currently working on.
2. Exaggerate and slow down your cues.
3. Make sure you give your child time to process your cues (the 45 second rule).
4. Respond to your child's verbal communication with nonverbal cues whenever possible.
5. Don't try to "get" your child to look at you. Whenever possible, wait for your child to look at you on his own.

If your child is not in the habit of looking at you, this can be difficult. However, it is important to resist the temptation to teach eye contact as a static skill. Doing so will teach your child to look at you when cued, but does not help your child to discover why it is important to look at you. By reducing verbal communication and increasing nonverbal communication, your child will learn that s/he needs to look at you to get important information in a natural fashion. This can be very challenging for parents, especially when your child expresses discomfort at your change in communication style. Be patient, with yourself and with your child. Over time, facial gazing and eye contact will increase naturally, and your child will learn to read nonverbal cues.