When Play Goes Away

This article is not exactly autism-related, but it speaks to the consequences of the decline of play at the preschool level and how this is affecting sensory processing in young children. Definitely worth a read.

The Decline of Play in Preschoolers

Note: I will be getting back to The Bridge series shortly. My “day job” has a slew of reports due this week, so my brain is a little fried. If I don’t get it out this week, I definitely will first thing next week!

The Bridge: 3,2,1…Contact!

Last week, we met our new client and collected as much information as we could on them. Among the data that we gathered was the fact that they LOVE toy trains. So, guess what I brought to the next session?

Peter likes to line up the toy trains, and then rearrange the order. He gets very excited whenever he does this. Rather than deter him from the activity (which is sometimes the first instinct), I decide to take a different approach.

First, I do not give Peter all of the trains that I have. I keep at least three of them. When he starts lining his trains up, I start to do the same and match his enthusiasm. In fact, I may actually get more into the trains, though not enough to disorient him. While doing this, I don’t immediately interact with him. This is only the second session, and as a newcomer I do not have that privilege just yet.

Then, it happens.

Peter pauses and makes brief eye contact with me…but it’s longer than any time previous. He then goes right back to his trains. My immediate response is: “Peter, you looked at me!” in a quiet but enthused tone. With this I achieve two things: I acknowledge his communication attempt, and I indicate that I am happy with this action. After that, I go right back to my trains as well.

One of the biggest problems I see here from Interventionists and Specialists is a lack of patience and a need to perform. This is especially true if a parent/caretaker if observing the session. It’s normal to feel this way, to feel nervous about how the entire family is viewing you, your actions, and your expertise. It is important, however, to remember why you are there, and to trust your intuition. When reviewing video with workers after their session, or in feedback meetings following sessions, the workers often knew what they should have been doing, but became intimidated by what they thought the family wanted them to do. If you feel this happening to you, don’t be afraid to have a conversation with the family about what the expectations are. Are there certain therapeutic approaches that they prefer? How willing are they to try other possibilities? If the client is verbal, you can also ask them. I have had treatment plan meetings where the clients (in my case, autistic preteens) had a say in their goals and their progress.

Back to Peter. More than likely, I will not push him much further beyond eye contact on the second session. I will also make a point to explain my method to the parents so that everyone is on the same page. That will save you a lot of confusion down the road: lay a plan out to the family, and review what you worked on at the end of the session before you leave.

Goal of session two: Acknowledgement/contact

Next week, we’ll look at how to build on that “blink and you’ll miss it” eye contact.

PS- The title is an 80’s reference. Can my 80’s Babies guess what I’m referring to? 🙂

Early Intervention Study

Below is a link to a Forbes article about a recent study published in The Lancet. The study involved a look at an early intervention technique for autism called PACT, which stands for  Preschool Autism Communication Trial. The approach essentially trains the parents to recognize communication attempts and cues from their autistic children. The intervention starts at preschool age, goes for about a year, and follows up with the participants around age 10.

While I really like the idea of giving power back to the families (unlike, say, many forms of ABA that leaves power with the professionals), I also see the author’s point of whether or not PACT truly had an effect. There is a lot of data analysis in here, so if you prefer to just get the abridged version, the first few paragraphs of page one and the last few paragraphs of page two will suffice.

Analysis of the PACT study