Autism is a "spectrum disorder," which means that symptoms and severity vary on a case-by-case basis. It is important to remember that even though the diagnosis is generalized, your child has a unique profile.
When relating to your child, it is essential to respect and consider his (or her) personal sensory needs. Factors to consider include:
Sensory input: Autistic children process sensory input differently. This affects the way they interact with the world. For example, a child sensitive to light may exhibit difficulty in public areas. A child sensitive to noise may need to be approached with a soothing tone and a quiet voice.
Deficits/Excesses: Deficits can range from problems with language, social interaction and eye contact. Excesses are sometimes characterized by self-stimulatory behavior, environmental rigidness, strange interests and fixations or self-injurious behavior.
Behavior: Autistic children often exhibit various behaviors. Examples may include body rocking/hand flapping (self-stimulatory behavior), banging their head/pulling their ears (self-injurious behavior), tantruming/throwing objects (communicative function).
Causes of behaviors can often be classified into five categories. It is important to pinpoint the category into which your child's behavior falls.
Behaviors with an environmental trigger
Some behaviors are direct responses to changes in the child's surroundings. For example, a child who is sensitive to transitional changes may walk into a familiar room where the furniture has been moved and throw a tantrum. The tantrum is a response to the difficulty adjusting or coping with the environmental change.
Behavior to receive sensory input
Your child may frequently exhibit a behavior because his body requires certain sensory inputs. For example, your child may rock back and forth, providing his body with a motion stimulus.
Behaviors for communication purposes
Autistic children often lack the tools of reciprocal communication. Instead of verbally expressing themselves, they may engage in certain behaviors with the intent of communicating their wants or needs. For example, a child knocking over a bottle of mustard may indicate that the child wants mustard. The child does not mean to misbehave; he is simply trying to communicate.
Often autistic children engage in certain behaviors to gain attention -- positive or negative. A child may learn that when he throws things that he can interrupt a conversation and turn the attention toward him.
Escape or avoidant behaviors
If a child finds a situation aversive, he may try to get out of it through certain behaviors. For example, in the classroom, a child may be asked to participate in learning the ABCs. If the child screams and the teacher asks him to leave the room, he has now learned that he can avoid ABC lessons by screaming.
Instead of seeing the behavior as negative, use it as a tool to better understand your child's world. Behavior is a means of communication for your child, and it is important to learn his language.
If the trigger is environmental, attempt to avoid or alter the uncomfortable surroundings. Use common sense, and alert those around you as to your autistic child's needs. Remember, your child is responding to something physical which has disturbed their sensitive sensory process and does not have the natural skills to communicate discomfort any other way.
If the behavior has a sensory trigger, offer a substitute which will allow you to interact with the child. The child who rocks his body back and forth may benefit from being put on a playground swing. Use the swing as an opportunity for engagement, such as singing songs and playing games, as you provide the child with the input he needs.
Behaviors derived from deficits in communication can be substituted with learned functional communication skills. Your child will probably not stop destructive behavior unless you can offer a replacement. For example, the child who knocks over the mustard bottle should be taught to say "I want..." or use PECs (Picture Exchange Communications), signs or pointing to indicate their desire for the object.
Now that you understand your child's "world," you can maximize interaction. Often times you can use the objects your child uses most confidently to lure a response or facilitate engagement.
A child Yael worked with was withdrawn and obsessed with lining up his toy cars. Yael saw the toy cars as an opportunity to facilitate an interaction with his mother.
He didn't respond when she said "let's race" because he couldn't understand the implied process of racing. When she broke it down into its basic components, he could follow her lead. Putting a car at the starting line, Mom said, "Car's here! Car's here!" and through verbal praise, physical hand-over-hand prompting, repeated modeling and imitation, he followed her through the simplified process of "Move Car!" to finally "You Win!"
She also helped him line up the cars by handing them to him. Then, she started putting the cars up to the bridge of her nose. As he looked at the car before he grabbed at it, he began to make eye contact.
Progress comes slow and in small increments, but nonetheless the interaction is valuable. If an aim for engagement seems out of reach, try setting a more simplified goal. Never give up your child's ability to interact with you.
Physical discipline with autistic children is highly discouraged. They may not correlate their behavior with your punishment. Also, they often learn to imitate your aggression.
Although they may not be able to communicate it, these children crave love and affection. One of the greatest myths of autism is that diagnosed individuals do not want or need attention and social interaction. Quite the contrary, they thrive in relationships when positive attention tailored to their sensory profile is available.
Siblings sometimes get jealous of the attention given to their autistic brother or sister. Therapy looks like playtime, and mom spends a tremendous amount of time with the autistic child. Talk to your child's therapist, and ask if the other child can participate in parts of the sessions. Also, make sure you don't neglect your other children. They may benefit from their own therapy or other outlets to express their feelings toward their siblings.
While the challenges of dealing with an autistic child can be great, the rewards are just as monumental. Learn to value each step as you build a relationship with your autistic child and come to understand his or her world.
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