How To Develop Interactions With Children Who Have Social Communication Difficulties
This post follows on from a previous one – Working With Non-verbal Children On The Autism Spectrum – posted on 1st August 2016. Here I describe how to move on with children who have social communication difficulties, once you have managed to develop the initial interactions I described in the earlier blog post.
A Flexible Approach
This stage can be very difficult, and I am always very flexible in my approach. If it is too stressful or the child can’t tolerate what you are doing, go back to the interactions, activities, and routines that they know and can tolerate. Inching forward can be a very slow process, and it is rarely straightforward. You can move forward and then suddenly go backwards, and when this happens it is best to go back to where the child feels comfortable. You will be able to move forward again, but perhaps not as smoothly or quickly as you thought. Don’t give up!
Introducing new activities can be really hard. It can take time to expand the resources you can use, the games you can play, the routines you can build up, etc. Every child is unique and there is not one right way to do this. One size does not fit all. It is a matter of finding what works with the child you are supporting, so don’t be disheartened if it takes time to move things on and expand the range of what the child will engage with.
Developing New Activities, Resources and Routines
I try to do develop and introduce new activities, resources and routines in the following ways:
- Add to routines which are already familiar and the child enjoys. For example, if you have a tickling routine with the child, do the following:
- Get the child’s attention.
- Make eye contact.
- Hold up your hands to show you are going to tickle the child
- Say “Ready! Steady!….” Pause, wait for eye contact, then say, “Tickle!!!” and tickle them.
- When you finish tickling the child, say “More?” and sign more (see right). Put your hands over the child’s hands and help them to sign more to request.
- After tickling the child, add another action that you know they will enjoy, for example spin them round and round or put a cloth over them and say, “Where’s Gemma gone? Gemma! Where are you?!!” Build anticipation by saying “Are you under the chair? No. Are you behind the curtain? No. Hmm, I wonder where she is? I wonder if she is under this? I, 2, 3, boo!” and lift the cloth.
Be careful that you don’t add too much onto routines too quickly. You know the child and you are the best judge of when and how much to add on to routines. If they don’t respond well, go back to the original routine and try again another time. I have found that if I keep trying, even if the child is not happy about the changes, it does help them to eventually move on and add to the routine.
- If you have a routine where you can pass a ball back and forth with the child, try adding on:
- Bouncing the child on a big aerobics ball while you sing a song, e.g. Zoom, zoom, zoom! We’re going to the moon or Humpty Dumpty and make the child fly off at the end of these.
- Introduce different balls, e.g. light-up ones, different sizes and colours, noisy ones, spikey ones, etc.
- Take it in turns to throw a ball into a box or a container.
- Put a cloth over the ball and say, “Where’s the ball gone? 1, 2, 3…..” Pause to wait for the child to look at you, and when they do, lift up the cloth and say, There it is!”
- Roll a truck back and forth rather than a ball so that you introduce a new toy.
- Put balls in the truck – pass them to the child to put in the truck to introduce taking turns (you pass a ball to the child, they put it in the truck, you pass another and so on).
- Make a tunnel from a cardboard box and pass the truck through the tunnel to each other.
- Roll a smaller car back and forth.
- Take it in turns to put the car down a cardboard tube.
I build on what the child is familiar with, adding little extras to the routines, making slight changes very gradually so that it is manageable. If it is too much, go back to what the child knows.
Working From Floor Level Towards Table Level
These activities tend to be on the floor, and I try to gradually work towards tabletop activities. I do this to develop attention and listening skills, and the ability to be directed and follow an adult agenda. Work on the floor is led by the child, gently building on what is familiar. Moving to the table helps the child learn to sit and focus, and develops their ability to work on activities given by the therapist/carer.
Ideas for moving from the floor to a table:
- Playing with balls on the floor
- Playing with a truck on the floor
- Putting shapes in a shape sorter on the floor and then on a table
- Taking turns to put shapes in shape sorter on the floor and then on the table
- Threading activities at the table
- Handing items to be threaded at the table
- Stacking items on a table
- Handing items to be stacked on the table
- Handing puzzle pieces to the child at the table, etc.