Monday, August 4, 2014

Social Prompting

"While we were at the pool yesterday Aiden found a little boy, about 5, he was interested in playing with. At first I thought the little boy wasn't interested and wanted Aiden to go away, but then something happened. After some brief social prompting, Aiden made a new friend. The little boy and Aiden made a connection and the two played until we had to leave. I was in awe while he actually engaged in a back and forth conversation, without my help. For Aiden, getting much past "hi" is hard with kids his age. They talked about likes and dislikes, about home life, and played games together. Our therapists would be over the moon to see that. I was sad to take him away, since I knew it meant so much to him. I don't think the other mom had any clue what that meant to me. I think if I had my sunglasses on I would have cried."

Social prompting is largely important and very easy to do. Modeling behavior is important, but talking your child with Autism through social interactions is also important. I wanted to take a moment to talk to you all about my personal experience with social prompting and tell you it’s not just a nice thought. Social prompting takes dedication and hard work on your part as a parent or caregiver. Sometimes when we, as parents, see our children struggling we just want take over them. So if we see our children struggling with social interaction, we want to talk for them. This is ok, for a short time, while they are learning. To talk for your child or loved one is to devalue them as a person. It demotes them. Let them speak for themselves as much as possible. Even non-verbal children and low functioning children can engage in a degree of social prompting.


It starts right away. Aiden, when he was in his 2's had no concept of personal space, and still sometimes regresses to that period. I would interject when I noticed discomfort in the other child's face. I would gently walk over to Aiden, remove his hand, and say "sometimes people don't want to be touched. You need to ask before you touch someone." Eventually it got better, now Aiden, for the most part, keeps his hands to himself unless prompted. For instance while teaching him the game of tag I would take him to the playground, run up to him in the midst of playing, tap him, and yell "tag you're it". I then would run away laughing, yelling "catch me Aiden!" He loves that. Teaching context of social interaction is important. When playing it is important for kids to understand they may be touched and that is ok, but when first meeting someone touching may not be appropriate.


During social interactions I would also point out the other person's facial expressions or bodily reactions to his presence, specifically a shy reaction. Children can be amazing teachers and individuals with Autism can learn from their peers with guidance. I remember Aiden's first recognition of shyness. We were at the park and Aiden ran up to a little girl. She pulled her body away and buried her face in her mom's leg. Aiden turned and looked at me with a "What do I do?" kind of face. I explained "Aiden she is shy. She doesn't know you and sometimes that is a scary feeling. We have to be gentle and very nice to her. Try telling her your name and ask her if she would like to play with you." The other mother seemed relieved. She tried to prompt her daughter to play when Aiden asked, but the little girl shook her head no. Aiden looked at me and seemed sad or disappointed. I said "That's ok. She's not comfortable yet, maybe she'll play in a little bit. Let’s go play on the slide and she can come later." The little girl never joined in, but Aiden now recognizes shy behavior and is nice toward children who exhibit this behavior.



Teaching my son to read the basic facial expressions of others has been important. Aiden has a doodle board, like a Magna-doodle I draw faces on the board and ask Aiden "is this a happy face or a sad face? Is this a sad face or an angry face?" Then we moved to my face. I would make faces at him and ask the same questions. He would laugh and laugh at that game. When he learns his words or math problems he gets rewarded for correct answers with a face drawn on the paper. He loves that.

While watching videos or cartoons I will talk Aiden through some of the things that are happening. For instance, if in his cartoon a child gets a ball taken away and looks sad I will prompt Aiden through that. I ask "Aiden what happened? Is that little boy/girl happy or sad? Why are they sad?" I ask him these questions so I know he understands what is happening. I learned a lot from my younger brother, who in his adult years has been diagnosed with ASD. I remember so frequently he would ask "what happened" while watching a TV show or movie. My parents were dumbfounded by that question and they would say "have you been watching? Then you should know". I now understand that this is common among individuals with ASD. They do not understand the social context of what is happening and are asking for clarification. They are watching and they do know what has happened, but they do not understand it. It’s like being plucked from your everyday life and suddenly dropped in the middle of a foreign country. All the mannerisms, greetings, gestures, common social interactions would be foreign to you. For instance, did you know is some Asian cultures you bow instead of shake hands? Of course you did, but do you understand the meaning behind the bow? You're bow level is representative of social class or status. A poor man bows lower than a rich man, though they both bow to greet the poorer man must bow below the level of the richer man. But a rich man will bow lower than a teacher, since teachers are highly respected in Asian cultures. There are many other rules for bowing; it is not always liked to social status or class. Failure to properly bow is considered disrespectful. That feeling, not knowing, not understanding, is how your loved one with ASD feels in social interactions they struggle to understand.


How do you socially prompt a non-verbal or low functioning individual? Some slight changes will do the trick. First, talk. Talk about what you see, point it out. You can use TV shows, cartoons, and other children for this. Even if it feels like your child isn't looking at what you are showing them, point it out any way. "Wow, Caillou looks sad" or "Look how happy Caillou is!" Also talk about social context "Oh no, Caillou fell and is sad. Look he's crying. He must be hurt. Poor, Caillou." (Note: Caillou is a kid’s show on PBS and Sprout network. I love that show since emotions are exaggerated and discussed by the narrator.) After talking about it for a few weeks, try introducing pictures. Hold up two pictures, one happy and one sad. Ask, "Show me the happy face", and allow them to point it out. If it does not work, don't be discouraged, use the pictures as flash cards and show them individually. Model the expression on your face. Eventually it will click. Never under estimate the intelligence of your loved one with ASD. After happy and sad are mastered, try other emotions like angry or scared. Carry a chart with you and ask how they feel. Have them point to the feeling on the chart.

So what happens after they say "hi"? I would notice Aiden would say hi and not know what to do next. He would constantly repeat "hi" and strain the polite responses from his peers. That's when we moved on. "Aiden, ask them what their name is" or "Tell them your name" is next. Eventually that turned interactions into "Hi, I'm Aiden." This was great until he did not know how to respond after he got their name. A child would say "Hi. I'm Logan" and Aiden would light up. They responded to him and then we had to practice the ultimate goal: "Would you like to play with me?" After mastering that introduction Aiden would play with his new found friend and the conversation would flow. The introductory paragraph to this blog is a Facebook status I typed today. Aiden needed less social prompting than ever before. His conversation with the other child went so much further than ever before. He found ways to identify in a meaningful social interaction with someone his age. The dialogue was open and two sided, with appropriate feedback from both children. Aiden listened and appropriately responded. 

Above all else be encouraging, prompt speech, even if your loved one is non-verbal. Teach them basic sign language for emotions, like happy and sad. Always reinforce the method in which they choose to communicate with you. I frequently prompt Aiden to "use your words." Words don't always mean verbal words. Be persistent. Your loved one has the ability to accomplish so much, even if they are non-verbal that does not mean they are not intelligent. Look at Carly Fleischmann:


Social prompting and education is an important part of any child's life. Typical children will learn social interaction by observation and practice. Autistic individuals need more than that. Plopping them down in a play group will not always solve the social struggles; in fact it may promote isolation. Engage them, challenge them, and be there for them through the interactions they face. 

We hope you've enjoyed our post and it gives you ideas how to engage your loved one in social interaction. Above all we hope it helps you understand the importance of social education and inclusion in your loved one's life. 

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