Foundation: Maintain a consistent teaching philosophy. The following language indicates that the child is confused and needs adult help: -This is too hard for me -This is confusing for me to understand -I can’t remember what I’m supposed to do The following language indicates that the child wants to escape from the current situation: -I don’t like this, I don’t want to do it anymore -This situation is too stimulating for me -I need some personal space The following language indicates that the child wants to maintain sameness, predictability, and routine. -I can’t stand these new activities anymore -I want everything to stay the same as before -I don’t want to stop what I’m doing -I’m not sure what’s going to happen next The following language indicates that the child wants to be exposed to something or have a social interaction with someone but doesn’t know how to Give me that -I’m bored and want your attention -I want to play with you Step 2: Consider how to change the child’s current situation to reduce the likelihood that he will send the above verbal messages. -If the child is expressing confusion and demonstrating difficulty understanding the situation, consider how you can make the situation more understandable, specific, or predictable. For example, you may want to simplify the content, rephrase or simplify the language, or provide some visual aids. -If the child is expressing an unpleasant state of mind, fix what is upsetting the child in the situation. -If the child is demonstrating stress and avoidance, consider avoiding the situation or reducing the amount of time spent in the situation. -If the child is having trouble switching activities, be sure to hint in advance how the next activity will change. -If your child expresses a desire to socialize with other children, be sure to provide him or her with opportunities for social enrichment. Be observant of other children’s positive responses when your child initiates appropriate communication requests. If your child is being ignored, consider ways to facilitate more positive responses from other children. If your child wants a desired item, find a way to get it whenever possible; or design a program that allows your child to get it after first completing an activity that he or she does not really enjoy. Step 3: If the child does have something to express, find a way to get him to express his wants and desires in a more appropriate way. -If the child is screaming because he is stuck on homework, teach the child to express his need for help by raising his hand, ringing a bell, sitting sideways in his seat, or other nonverbal behaviors. -If a child bites his hand when asked to set the table, teach him to say, “I need someone else to help me with this.” -If the child hits when he feels overwhelmed and wants to escape, teach the child to say, “I don’t like it here.” -If a child cries or bangs on the furniture when asked to turn off the TV and get ready for bed, teach the child to say, “I want to finish watching this show before I put on my pajamas.” -If your child pats other children as a means of initiating interaction, teach your child to say, “Can I come play too?” Step 4: Practice new ways of communicating -Model more appropriate phrases or nonverbal signals that the child can use to express requests and wishes. -Have the child practice the new phrase or behavior before a situation that requires him to say or do something. -In this situation, remind the child to use the new phrases and behaviors he or she has just learned. Step 5: Reward your child by showing him that his needs are being met – Help your child immediately when he asks for help Step 6: Make sure your child learns that problem behaviors no longer satisfy his or her needs. Give your child no other option for satisfying his or her needs than to use the new, appropriate methods you have taught him or her. Ignore problem behavior whenever it occurs, but provide appropriate cues for his new way of communicating. Strategies for Establishing Proper Behavior 1. Establish a specific set of rules that are always reinforced in a consistent manner. 2. Make sure the child understands what he is supposed to do next, either in the form of writing or even in the form of a picture explanation. Use pictures to describe the steps to complete a task. 3. Put your requests to him in the form of “what you should do” instead of “what you should not do”. For example, “Put your hands on your knees” instead of “Don’t knock.” This will make your command clearer so that it doesn’t seem nagging. More importantly, it will help your child remember what proper behavior to adopt in the future. 4. Help your child establish a routine for morning and evening activities. If needed, outline these routines in words or pictures. These activities should have clear boundaries, either by timer or by visual cues that clearly indicate the beginning and end of the activity. Give specific cues to indicate that the activity is coming to an end. 5. Use the child’s preferred activity to reward him for completing an activity that he does not like very much. 6. Limit your child’s indulgence in meaningless activities by having clear rules. For example, your child asks you three questions every night about his favorite topic. Activity strategies for different times of the day Morning: It is very beneficial to try some appropriate methods to calmly transition your child from sleep to activity. Evening before bedtime: It is very beneficial to establish a bedtime activity routine, such as going to bed regularly and doing some of the same bedtime activities. Give your child enough prior reminders before bedtime arrives, which can take the form of counting down (e.g., 30 minutes, 20 minutes). To quiet your child, give him or her some quiet activity, such as bedtime reading. Principles for teaching your child social skills: Make the abstract concrete. Give rules such as “When you start a conversation, maintain eye contact”. Break down complex behaviors into steps, with a beginning, middle step, and an end. Use visual cues, such as two-way arrows to indicate rotating activities, or back-and-forth conversation activities. Help children with activity transitions. Provide a written schedule of activities. Use predictable routines in each activity, such as open-ended discussions, group activities, role-playing games, eating a quick meal, telling jokes, and saying good-bye. Motivational incentives Establish realistic and achievable goals and reward the child for reaching them. Generalization Establish good communication and cooperation between parents and therapists. Complete “out-of-class assignments” outside of clinic time, such as calling another group member and talking on the phone for a while. Go out and practice the skills learned in social situations, such as talking in a restaurant. Social body language: appropriate eye contact, maintaining appropriate social distance, volume and facial expressions. Atypical training programs: Friendship skills: greeting others, joining an activity group, taking turns, sharing, negotiating and compromising, following group rules, understanding the qualities of a good friend. Conversation skills: start, maintain and end a conversation; rotate talking; make comments; ask questions of others; express interest in others; choose appropriate topics. Understand the thoughts and feelings of others: express empathy, understand others’ perspectives, and deal with bad feelings. Social problem solving and dealing with conflict: how to deal with people saying “no”, how to deal with being teased and rejected. Self-awareness: understanding autism spectrum disorders, personal efforts, unique differences from others, self-acceptance.