MIMI’S parents are worried. Their beautiful three-year-old daughter does not seem to want to be with them.
Indeed, she seems to go out of her way to avoid their hugs. She lines up her dolls in a row and always in the same order. She gets upset if they try to play with her and mess up her dolls.
When she is not playing with her dolls, she sits staring into space, sometimes wiggling her fingers close to her eyes. She doesn’t call “mama” or “papa” and doesn’t respond to her name. And her tantrums! Mimi screams and cries for a reason no one quite understands and her parents are at a loss.
What does she think about? What does she feel? Will they ever understand her? How can they help her communicate?
Mimi was diagnosed with autism spectrum disord er (ASD). It is a term used by many professionals to describe children who have trouble engaging emotionally with people, playing and communicating.
While these three “core” difficulties are present in all children with ASD, they are affected in different degrees. Thus, you may hear of such terms as “mild autism”, “highfunctioning autism” or “severe autism”. ASD is also associated with many different terms like Pervasive Developmental Disorder, Asperger's Syndrome, Semantic-Pragmatic Disorder and Hyperlexia.
Labels can be intimidating, the information attached to them overwhelming and treatment options mind-boggling. Yet at the core of this is a young person with unique strengths and challenges, yearning to make sense of her world.
How does a child with ASD communicate?
Mimi’s parents thought: “How can we help her communicate?”
When we think about communication, we think about using words. Yet communication involves more than just words. Pointing, pulling someone to a desired object, grunting, crying, screaming, hitting the table, all serve to communicate what a child wants or how she is feeling.
Let’s take a look at how and why Mimi communicates:
> We know that Mimi screams and cries to communicate frustration.
> We know that she avoids hugs to communicate dislike for touch.
> We know that she covers her ears to communicate her dislike for vacuum cleaner noise (and perhaps other similar noises).
> We know that she chooses dolls to communicate her like for this toy above other toys in the house.
Mimi’s communication is nonverbal. Nevertheless, her way of communicating conveys meaning.
When we know the purpose (the hows and whys) of the child’s communication, we can help her develop a more effective way of communicating.
We may show her how to point to the vacuum cleaner and shake her head for “no”, or she may learn to use a picture to communicate “no”.
Why do children with ASD behave in unusual ways?
We make sense of our world through movement, sight, sound, smell and touch. The child with ASD may not be able to make sense of these sensations the way we do. They may be over-sensitive to certain sensations (a small amount of a sensation is too much for the child, requiring her to avoid it) or undersensitive (the child requires a lot of the sensation to stimulate her, thus she seeks out that sensation).
Mimi appears to be over-sensitive to touch as she avoids hugs. She may also be over-sensitive to certain sounds, covering her ears when she hears the vacuum cleaner. She may be under-sensitive to visual stimuli, seeking out this sensation of sight by wiggling her fingers close to her eyes.
Not all children with ASD behave in unusual ways. Knowing the child’s sensory preferences helps us understand situations and environments that may make her better able to communicate.
How does the child with ASD learn best?
We all have different styles of learning that help us acquire information and skills. A child with ASD is no different. The learning styles listed below are not meant to be exhaustive, but they may describe your child:
> Rote learners: These are children who prefer to learn by memorising information, like letters and numbers, by rote. They may be able to recite information word for word, but they may or may not understand it. Rote learners may benefit from learning things in order.
> Visual learners: These children may learn best by seeing things. They may be attracted to TV and eye-catching picture books or even printed words.
> Auditory learners: These children learn best through hearing pieces of information.
> Gestalt learners: These are children who learn things in chunks. They may learn whole phrases and sentences. They may imitate and repeat whole sentences from their favourite TV show when communicating with people.
> Hands-on learners: These children learn best by touching and manipulating things. They do well in environments where they are allowed to explore objects. When we take a closer look at how and why a child communicates, her sensory preferences and learning style, we begin to understand how these factors affect the way she engages with people.
No two children with autism spectrum disorder are alike. A child may use words, another may use sounds or actions. Nevertheless, our understanding allows us to respond to and engage with each child in different, yet emotionally meaningful, ways.
Each positive response to a way of communicating promotes interaction and demonstrates the connection between speech/ language and actions. Each positive response conveys interest in what she is saying, even if she chooses to say it with sounds or actions.
Farah A. Mohd Alkaf is a speech language pathologist and a member of the Malaysian Association of Speech and Hearing. She will be conducting a parent-and-teacher workshop on Engaging Children With Autism Spectrum Disorder in Ipoh, Perak, on July 9, and in Petaling Jaya, Selangor, on July 30. For more information, contact Coreen at (013) 3301-728 or email coreen@trainingtrack.biz.
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