Communication: Just a Few Changes Make All the Difference……

January 25, 2012

By practicing the following changes in our style of communication, many children diagnosed with Autism and receptive/ expressive language delays may increase their language and social skills, peer interactions, expand play skills, and follow directions with greater confidence.

Eye level Contact: To increase social interaction and gain eye contact with your child, remember to kneel down to his/ her eye level. Face to face eye contact allows the child to see your whole face, imitate facial expressions, and respond to your verbal directions. This position also gives you an opportunity to put your arm around your child’s waist to face him toward you, touch his/her shoulders to gain attention, or model hand gestures with hand-over-hand assistance.

Tone of Voice: Your child might be sensitive to the pitch and tone of your voice. If your child covers his ears, winces, or looks away when you speak to him, practice lowering your tone of voice to a moderate level. When you are at your child’s eye level, speak slowly and clearly.  Use visual aids to enhance communication. For example; tap on the chair and say “Sit in the chair”, or show an item or a picture of where you want your child to go.

Exaggerated facial expressions/ hand gestures: If your child does not imitate your facial expressions and hand gestures, practice exaggerating your face and hand movements as a model. For example, when your child sees you from across the room, make a large happy face and big eyes. Wave your hands in a large swooping motion, as opposed to wiggling your fingers in tight/ small motions. A person standing next to your child can help him/ her respond by assisting to wave back in the same fashion.  Exaggerated facial expressions and hand gestures allows your child to feel the sensation of movement and encourage muscle memory, which promotes communication.

Body Proximity: Avoid speaking to your child when his back is to you. Often, children have difficulty filtering out the sounds in a room, and distinguishing a parent’s voice at the same time. Try moving close to your child and mirroring his position before speaking to him. For example if your child is on the floor playing with cars, join him on the floor. Gain his eye contact by bringing a toy to the side of your face, then speak to him/ her.

First____, Then_____…. When asking your child to follow directions, remember to keep your child’s motivation in mind. He/ she may not prefer to put on his shoes, for example. But if he/ she wants to go to the park, incorporate that as a reward in a two step direction. For example “First, put your shoes on. Then, we will go to the park.” A simpler version could be “First, shoes…Then, park.”

With a few adjustments, and a lot of practice, children diagnosed with Autism and receptive/ expressive language delays will learn new ways to respond to their environment, and expand their communication skills. Adults can offer the support a child needs by changing our communicative habits to meet the needs of children.

 

-April Kumlin, Speech and Language Pathologist Assistant

 

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Teaching Social Skills to Your Child with Autism – At Home!

January 20, 2012

What are social skills and why are they important?

Social skills are the skills we have to get along with other people. Social skills can be as basic as saying hello and good-bye, or smiling and making eye contact with people we know. They can also be more difficult, like the skills we use to negotiate. Some people learn social skills easily and quickly, whereas others find social interactions more challenging, and may need to work on developing their social skills. It is common for children with autism to have difficulty with social skills. Luckily, social skills are like any other kind of skill – they can be learned. Below is a list of social skills: (information and skills taken from: Embrace the Future)

Basic interaction skills

Making frequent eye contact.

Smiling when greeting people and talking.

Showing “confident” body language: an open, direct stance, not fidgeting or twisting.

Basic politeness: saying please and thank-you, saying hello and good-bye.

Showing interest in others (asking how their day was).

Building and maintaining friendships

Approach skills: being able to talk to someone who you don’t know well.

Sharing decision making (not always insisting on having one’s way).

Showing appropriate affection and appreciation.

Being supportive (showing concern when a friend is having a hard time).

Thoughtfulness: thinking about what might be a nice thing to do for your friend.

Making conversation

Taking turns when talking.

Listening and showing interest in what others have to say.

“Small talk”: being able to chat about unimportant things.

Nodding and smiling to indicate that you are following along.

Using humor.

Knowing when to disclose personal information and when not to.

Empathy

Noticing other people’s feelings.

Expressing concern at others’ distress.

Being able to recognize what someone else might be feeling.

Showing sensitivity to others’ feelings when communicating.

 

How do I teach social skills at home?

Social Skills to try teaching at home:

  • Say Hello
  • Take Turns
  • Share
  • Wait
  • Listen
  • Stay on Topic/Reciprocal Conversation
  1. Target one skill at a time so your child has time to understand and succeed before moving on. Teach skills directly by breaking down a skill into smaller parts as shown below:

Target social skill: “Say Hello”:
1. Turn your body/shoulders to face the person.
2. Look in his/her eyes.
3. Say hello

  1. Use positive reinforcement to reward acquisition of each part of the social skill targeted. External reinforcement may be necessary to motivate a child with autism. An explanation of why the skill is important may be helpful depending on the child’s level of understanding. There are various types of reinforcement to provide to the child when teaching new skills including:
  • Watching a favorite TV show
  • Playing briefly with a novel toy
  • Verbal Praise
  1. Start teaching the social skill in a 1:1 setting with no distractions. Have your child sit across from you at the table, and prompt the correct response initially.
    1. After the skill is mastered in one setting, practice in settings where the social skill is appropriate. Generalizing the social skill is often the most difficult challenge, so try to keep reinforcement high for the child. Once a social skill is mastered in a generalized setting, introduce a new target. To maintain mastered skills, it is helpful to verbally praise the child using the social skill appropriately.
    2. Your child will likely need practice in a variety of settings before fully acquiring the skill. For example, a child may learn the social skill “say hello” to a friend who comes over for a playdate, but have difficulty using the skill at school where there are more distractions. Therefore, it is helpful to practice the skill in a variety of environments.

Information adapted from:
Autism Social Skills
Embrace the Future

 

-Michelle Smith, MS, CCC-SLP


You don’t have to brush your teeth – just the ones you want to keep

January 20, 2012

Tooth brushing and visiting the dentist are two of the hardest things to do for our kids with sensory issues. The sheer thought of someone going into their mouths can be enough to send our children into meltdown mode. Here are some practical tips that can help both dreaded activities.

Tooth brushing:

Make it feel better. To desensitize gums, and help your child tolerate using a toothbrush, massage gums with a rubber finger cot, Toothette or Den-Tips (available in many drugstores), use a Z-Vibe or other oral vibrator, or swipe gums with a washcloth.

Change toothpastes. If your child can’t tolerate toothpaste foam, try non-foaming toothpaste such as Orajel Toddler Training Toothpaste.

Make it predictable. Develop a predictable routine for when and how to brush. Help your child choose the brushing pattern. For example, they could always start with top teeth and to brush from left to right, front to back. A consistent brushing pattern will help your child learn to sequence this complex activity, help them to predict when and where they will feel various sensations (instead of feeling assaulted by the toothbrush) and help them feel proud about keeping their mouth and teeth nice and clean.

Visiting the Dentist:

Do a trial run: About a 2-3 weeks before your initial appointment, ask the office if you could stop by and take a tour of the office. This will allow your child to see the waiting room, and explore the office so that it is not a shock on the day of the appointment. If the setting feels familiar, your child will be less likely to meltdown on the day of the appointment.

Sensory solutions: Ask the office if your child could wear the lead apron throughout the appointment. The apron is very heavy and would serve as a weighted blanket, which is calming. Bring headphones for your child to decrease the sounds of all the equipment.

Practice, Practice, Practice: Call your local dentist and ask what they typically do for an initial visit and practice those at home (i.e. explore and play with rubber gloves, vibrating toothbrush, lying back with a bright light overhead). Going through these activities in a safe environment with help your child tolerate them in the dentist office.

For more ideas on practical solutions to everyday sensory concerns visit Raising a Sensory Smart Child.

-Larissa Ksar, MS, OTR/L


Slipping Concepts into Your Daily Routine: Suggestions and examples for teaching concepts as part of you and your child’s daily routines

January 18, 2012

 Play Time

  • Nouns: ball, top, book, blocks, names of toys, bubbles, car
  • Verbs: kick, roll, push, pull, throw, drop, catch, stack, slide, swing, jump, run, stop, go
  • Prepositions: under, in, on, through, up, down, over
  • Colors and shapes
  • Other terms: all done, fall down, uh-oh, I see

 

Bath Time

  • Nouns: water, body parts, boat, soap, bubbles, shampoo, duck, towel
  • Verbs: splash, pour, turn on, turn off, squirt, blow, pop, rub, wash, point
  • Adjectives: wet, dry, cold, hot, big, little

Meal Time

  • Food items: names of foods, types of drinks, snack foods, vegetables, dairy products, fruits
  • Meals: breakfast, lunch, dinner, snack
  • Verbs: eat, drink, cut, chew, wipe, open, close
  • Utensils: plate, cup, spoon, bowl, fork
  • Adjectives: more, cold, hot, full, empty, all gone
  • Expressive terms: mmmm, yummy, more

Dressing time

  • Body parts: eyes, arms, legs, head, neck, fingers, feet, toes, knees, shoulders
  • Clothing items: sock, shirt, pants, dress, shorts, shoes
  • Colors
  • Verbs: zip, pull, sit, stand, snap, button
  • Prepositions: in, on, off, open, close
  • Relational terms: back, front, first, next, last

Belen Macias, MS, CCC-SLP


Rainy Day Fun!

January 11, 2012

Winter time with a toddler can be tricky sometimes with the weather. You might find yourself not being as active as you might during the spring or summer months because the go-to favorite of the park is not possible in the rain. Here are a few ideas of developmentally appropriate activities for toddlers in the community and at home to help keep busy.

In The Community:

Þ    The Children’s Discovery Museum

  • The Children’s Discovery Museum offers a few exhibits that are sponsored by First 5, Santa Clara County. Therefore, they are designed specifically with children under the age of 4 in mind. Exhibits Sponsored by First 5: The Wonder Cabinet and WaterWays

Þ    Story Time and Other Activities

  • Each library is different, but typically they each offer different opportunities for toddlers. Here are a few examples:
  • Pajamarama Storytime: Cuentos En Espanol y Ingles: Bilingual Storytime on the fourth Friday of every month, 7-8pm atBarnes and Noble, 2200 Eastridge Loop, San Jose, CA 95122

At Home:

Wild Animal Safari: Sneak outside with as many stuffed animals as you can find and hide them in your yard: up trees, inside shrubs, behind bushes. Next, tell the children it’s time to go on a wild animal safari! They’ll have fun discovering their beloved creatures in such unfamiliar places. (Taken from Bay Area Parent)

Flashlight Hunt: Playing in the dark can be fun! Before you start this activity, go into your child’s room or some other room in the house and place some of his favorite toys/books around the room. To begin this activity, you can review the concept of a lighted room and a dark room. Then let your little one turn the light switch off and turn the flashlight on. Ask him to try to find his teddy bear with the flashlight. As he swings the light around, you can mention all of the thing you see until you get to the teddy bear, or whatever he was “hunting” for with the light. You can also review the different parts of a room…ceiling, floor, window, door, closet, bed, dresser…by flashing the light on each. (Taken from Toddler to Toddler).

Toddler Bowling: Line up three or four (or more) empty plastic soda bottles or unopened paper towel rolls. Show your toddler how to roll a large rubber ball to knock them over. (Taken from Family Education)

-Alana Garcia-Chavez, M.S., CCC-SLP


ASHA Convention 2011: San Diego, California

January 10, 2012

The 2011 American Speech Language Hearing Association (ASHA) Convention was held at the San Diego Convention Center in San Diego, California, November 17–19, 2011. Many therapists from CSLOT, along with more than 12,000 attendees, attended the convention, where we enjoyed informative classes, caught up with colleagues, and learned new and innovative approaches to speech language pathology!  From classes on voice disorders to brain injuries to augmentative and alternative communication (AAC), attendees had a wide variety of courses to choose from at this year’s convention.

One of the classes featured a panel of researchers who presented their study of late-talking toddlers. The study aimed to discover which therapeutic methods were best for late-talking toddlers. After thousands of studies were examined and scrutinized, it was found that there is no single approach that is best for all children. After taking into consideration family values, it was found that an eclectic approach which combined multiple language stimulation methods was found to best promote expressive language. The researchers presented more than 15 effective language stimulation methods; a few of them are listed below:

  • Expansion: the adult expands on the child’s “baby-like” utterance into a more adult-like form (e.g.:  Child says:  “horse”. Adult says “Yes, that is a horse.”).
  • Self-talk: the adult uses short phrases or sentences to convey your actions to the child (e.g.:  Adult says “I am washing dishes”).
  • Parallel talk: the adult uses a short phrase or sentence to describe what the child is doing.  This technique highlights the action (e.g.:  the child raises a cup to his lips. Adult says:  “You are drinking” or “(Child’s name) is drinking”)
  • Description: the adult uses a word, short phrase, or sentence to describe what the child sees or is playing with.  This technique is object centered (e.g.:  The child picks up a truck.  Adult says:  “a truck” or “It’s a truck” or “a blue truck”).

Further, it was found that environmental arrangement is extremely important. For example, a cluttered play space was shown to be overwhelming and difficult for the child and communication partner (therapist, parent, teacher, etc), to communicate. The child also responded more frequently when patterns and routines had been established within the environment.

Lastly, the power of patience and wait times were emphasized. Rather than giving the child a bombardment of prompts/cues, it is more powerful to listen to the child, watch their response, then add to the interaction. Following the child’s lead is a crucial part of intervention, especially with late-talking toddlers.

-Katey Sellers, M.A., CF-SLP


SCERTS. It makes for a catchy acronym, and rolls of the tongue easily, but what does it stand for?

January 9, 2012

Speech and occupational therapists from all three CSLOT offices, along with over 100 fellow therapists, administrators, parents, and educators, spent October 25th and 26th in South San Francisco, discovering what SCERTS was all about and how to implement this model—a model developed for individuals who have autism spectrum or related disorders—into their practice.

We began by briefly reviewing that SCERTS refers to social communication (SC), emotional regulation (ER), and transactional support (TS), after which we jumped right into the main attraction—learning how to put SCERTS into action!

We all had our handouts and pens ready, and our eye and minds wide open as we listened to and learned from our wonderfully enlightened presenters, Emily Rubin and Barry Prizant. If you’ve never heard this duo speak, you must sign up for their next speaking engagement right now! I must say that they are certainly a force to be reckoned with when it comes to public speaking. No question about that!

Emily and Barry presented videos and shared detailed power-point notes, worksheets, and case-studies, while answering questions, and supplying us with useful tools like lists of “frequently used objectives and supports” to help all of us better understand how we can take this knowledge and these tools and implement them into our practice.

Our presenters repeatedly told us that they would change our way of thinking from “sure, I think I can do this” to “yes! I know I can do this,” and I believe most of us left this 2-day institute feeling empowered with new knowledge and new skills to work with individuals who have ASD and their families; we left feeling like we’ve been challenged; we left feeling like we know we can!

So, I’ll finish with another acronym. FYI: I felt incredibly lucky to get the chance to learn about the implementation of this comprehensive and multidisciplinary approach, and be in the presence of two incredible collaborators who were able to teach me so much in just a short time.

-Diana Pritsker, M.S., CF-SLP