April is Autism Awareness Month - Day 19

Remediating Autism?

To address the core deficits of autism* any remediation program which seeks to restore healthy relationship functioning in a developmental way, needs to empower parents–not professionals–in establishing the primary relationship through which this can be achieved.

* For references, download the new Autism Spectrum Quarterly article by Dr. Steven Gutstein: “Relationship Development Intervention–Developing a Treatment Program to Address the Unique Social and Emotional Deficits in Autism Spectrum Disorders."

But what can you do to help, as a relative, friend, teacher or aide?

1. Consider "lending an ear".
Understand this will be a marathon for the family, and not a sprint. Take a deep breath. Relax. Then consider lending an ear.

A remedial autism program is not focused on age-appropriate, “fitting-in” skills. Rather, it is a long-term approach focused on long-term quality of life goals: genuine emotion-sharing, true friendships, community involvement, independent living, etc. For many, just believing this is possible is sometimes the most difficult part of getting started or maintaining enthusiasm during the inevitable ups & downs, so offering some open-hearted listening to parents as they work through this, can be a major help.

2. Be patient & celebrate the small miracles.
Understand this is a developmental process which starts at the beginning, even if the person with an Autism Spectrum Disorder (ASD) is starting the remediation process as an adult. Be as patient with a person on the spectrum beginning remediation, as you would be with an infant.

A 14 year old on the autism spectrum may have good language or IQ, but may have completely missed out on the 4,000 hours of practice that a typical three-year old has used for building trust, experiencing the payoffs of being excited or soothed by parents, communicating non-verbally, coordinating with others, and enjoying basic relationship competence. So, don’t expect the motivation or skills for advanced abilities like typical friendships to occur, until well into the remedial work (Stage 8, of the RDI® Program.) In the meantime, celebrate the small miracles you will see unfolding.

3. Provide opportunities for the person with ASD to engage with you.
Understand that the only person who can really remediate the autism is the person with the autism themself. Provide ample opportunities for them to engage, without direct prompting or pressure. If persons with ASD are to generalize their abilities over a lifetime, they need daily reserves of mental and emotional energy to do the work only they can do, and the right opportunities to develop their own inner drive & confidence to succeed.

Create an Inviting Communication Environment
Changing the communication environment for a person on the spectrum can make a dramatic difference in their desire to engage with you and to use their communication in new and vastly expanded ways. Here's how you can help:

• Increase the importance of your own non-verbal communication.
• Slow down your pace of talk and use fewer words to increase mental processing and thoughtful speech.
• Do not reinforce non-communicative speech.
• Try not to use more words in any utterance than the person with ASD does. If he or she normally speaks in two or three word phrases try to keep your own phrases to that length. If the person is completely non-verbal, use very short phrases.
• Don’t continue to talk until the person with ASD provides a meaningful response to the first set of words that you have spoken.
• Emphasize quality of communication over quantity.
• Make sure that thoughtfulness is preceding speech. Allow plenty of thinking time before expecting a response (wait 45 seconds).
• Use a ratio of 80% declarative (experience-sharing) communication to 20% imperative (means-to-an-end) communication:

Declaratives include:
• Sharing emotional reactions
• Comparing/contrasting
• Reminiscing
• Brainstorming ideas
• Planning future experiences
• Affirming your emotional bond
• Increasing coordination
• Repairing misunderstandings

Examples:
• “Woohoo!” “Great!” “We did it!”
• “I like the black car more than the blue car.”
• “Yesterday we saw a cute dog.”
• “The red one might fit.”
• “Tomorrow we'll make chocolate waffles.”
• “I love you.”
• “This is too heavy for me.”
• “Here I come.”
• “Sorry. I meant before lunch, not after lunch.”

Imperatives Include:
• Obtaining desired information or objects
• Influencing someone to provide a specific response
• Reciting scripted words in response to an associated setting
• Cueing for a specific response
• Testing knowledge

Examples:
• “Put your coat on.”
• “Which one do you want?”
• “What did you do today?”
• “Give me that balloon.”
• “Stop that. Come here.”
• “Say ‘thank you’.”
• "Wave good-bye.”
• “What color is this?”
• “Look at me.”
• “What is the right answer?”
• “What do you call this?”