Why do I need to keep my child on their early intervention program when they reach school age?
written by Vivienne Morris, Director AES
Parents are most often of the opinion that, when their child goes to school, school will take over and they will learn what they need to know. School as it appears to parents, is the benchmark for learning.
Do children with autism learn as their peers do, or in a similar fashion? Will the youngsters ‘get it’ by placing them into a typical environment. Has their early intervention program taught them enough skills with few hours, to manage appropriately at school, given legal school entry is now pre-primary? Will school/day care teach them to model play and social skills, so they can mix with their peers successfully? Well I’d say ‘not nearly enough.’
Child development involves an astounding amount of learning in a remarkably short time. Children with autism are typically far behind their peers in a broad range of prerequisite skills, even as young as age 2. There is simply no way they will learn ‘naturally’ if they are not prepared with the base skills they need in order to understand what is happening in the world around them.
Learning in a Class Environment
In order to give you an idea of exactly how much learning is involved, let’s look at the example below.
Suppose your child is in school and the teacher is talking about caterpillars and butterflies. Typical children will learn this in one lesson and have a lasting interest in the subject that will help them enjoy the world and give them something they can share with you and their friends. But consider what they first have to know in order to learn this lesson:
- The categories of insects and food (these are subcategories of animals and specific food items, which need to be taught first)
- The idea of one thing changing into another (pupa – to butterfly)
- The concepts of eating and sleeping (and the generalisation – dog eating, sister eating, eating yogurt, eating meat, eating bugs – sleeping in bed, a kennel, a cocoon)
- The preposition "around" (as in "spins a cocoon around him")
- Sequencing (first he spins...then he opens...)
- Past vs. present (he was …. he is now)
Now, the skill pre-requisites designed to teach the curriculum based skill as cited above within the classroom, does not include the required skills to even begin that process. Let’s have a look at what they may be.
Attending skills just to pay attention to the teacher in the first place e.g. eye contact, feet still, hands in lap, attending to person/ attending to task or object (joint attention deficits).
- Unpredictability and noise of the presence of others can be disconcerting
- The ability to sit still and quietly on the mat (for an extended period), with children all around – girls with long hair and ribbons/ clasps/ boys with t-shirts of e.g. Thomas the Tank Engine/ Batman and number of other distracting objects or situations.
- The ability to listen for a period of time and keep track of what is being said (unaware of interpersonal and environmental cues that help guide social exchanges and thus miss opportunities to learn and participate in a) classroom routines, b) activity themes, and c) social interactions
- No self-regulation issues / able to self-calm using learned strategies (versus frustration/ anxiety from a lack of overall understanding of the subject matter or too much content or too many words)
- Not distracted by light and colours and class art around the room.
- Not be irritated by an itchy carpet or have a ‘focal interest’ in the pattern/ design of the carpet. If not the carpet, odd pieces of fluff, string, or other small, seemingly unimportant scraps left over from previous activities
- Have no stereotypy or self-stimulatory behaviour, such as:
- Visual: staring at lights, repetitive blinking, moving fingers in front of the eyes, hand-flapping, looking at the straight lines of tiles/ desk edges.
- Auditory: tapping ears/ hands covering ears, snapping fingers, banging the table, making vocal sounds, humming.
- Tactile: rubbing the skin with one's hands or with another object, scratching, picking at skin.
- Vestibular: rocking front to back, rocking side-to-side.
- Taste: placing body parts or objects in one's mouth, licking objects.
- Smell: smelling objects/ clothing, sniffing people, smelling hair.
Note: this is not an exhaustive list, but a good starter when looking at challenges that might hinder or test how and when learning takes place for our kids.
Therefore, expecting a child lacking the prerequisites to learn ‘naturally’ would be as misguided as placing a baby in the same classroom!
Learning about Play
Let’s do the same exercise as above using ‘play.’ Suppose your child is at recess or lunch and the other children race off to play a game of football. What would this look like for your child? Let’s break it down to see what that looked like.
Your child would need to:
- Be able to approach the other children and make appropriate contact (‘hey guys, got room for me in the team”)?
- Understand what game they are playing (soccer. Aussie rules)
- Know the rules and the positions (ruck, midfield)
- Have some level of skills (so the other children don’t dismiss them immediately because they can’t keep up)
- Able to hand over the ball to another if there was an infringement (turn take/ share)
- Accept a loss as well as a win without a negative reaction
- Able to understand that bumps and crashes are part of the game and not a hostile approach by a peer
- Understand what game they are playing (soccer. Aussie rules)
- Accepting that peers will call out and at times appear ‘bossy’
- Be toilet trained (day-time at least)
- No resistance to new activities or rules
Now, the skill pre-requisites designed to teach the sport based skill as cited above in the school ground, does not include the required skills to even begin that process. For example:
- Listening skills (kids call their name or yells out eg to kick the ball).
- Attending skills (focused and being alert).
- Cope with the unpredictability factor.
- Sports jargon (keeping up with the kids and feeling included).
- Not become distracted (joint attention - don’t miss the ball when a peer kicks it to them).
- Ability to keep calm (when situations/ decisions don’t go their way).
- Play oriented (join in, laugh, understand the ‘jokes’, fooling around).
- Know the rules of the game..
My families ask me all the time ‘I just want him/her to play and have fun.’ This request seems like the easiest thing in the world to implement. After all what youngster doesn’t want to play and have fun! However, you can now see having read the information above that it is just not that simple at all. Play is even more difficult to teach than academic skill acquisition. Our children thrive on structure and learning that has a beginning and an end.
Play is not at all like this and it has more social nuances and rules, for example:
- When your child says: ‘Can I play?’ The peer reacts with a shrug of the shoulders. Your child is now uncertain and feeling a little fragile – after all what does this mean? ‘Can I play or not?’ .
- Play is open ended – ‘so how long will this go on?’ ‘I’m not sure what this means – I’ll just leave now/ get upset/ feel frustrated/ and so on’.
- Peers run off (change of plan or game) – your child takes this badly. ‘they don’t like me, they are being mean to me, etc’.
- The game moves quickly, the ball changes hands regularly – ‘it’s not fair I did not get a proper turn.’
- He tripped me and made me fall on the ground. ‘He said sorry and said it was an accident but he did it on purpose. I’m going to tell.’.
Take care not to interpret social deficits as a lack of desire or avoidance of social interaction. There are so many processes and subtleties for play and social interaction to occur. It can be so overwhelming that our kids just don’t know where to begin!
Children with autism in the most part, have vastly different learning style profiles from their typical peers. Additionally, children with autism also have different learning style profiles from each other.
Once parents understand why the pre-requites to learning are so very necessary and why school (and daycare) will be unable to furnish your child with all that is required to make learning happen ‘naturally’, then it all makes better sense.
Parents who know this to be true, are no longer confused and in two minds as to what treatment options will provide the best outcomes for their child. The window of opportunity is a very small one, so what our kids need to learn must be taught as early and as intensely as possible, and include the variables of skill acquisition and everything in between.
I have included below some information that speaks to ‘the why’ of having your child enter an intervention program as early as possible. As mentioned above, the development of the pre-requisite skills that are critical if it is your wish to have your child navigate the difficulties of learning, to where it may be possible to learn the life-cycle of a butterfly or simply play a sport with their mates.
Why start intervention so early? Source: http://www.autism-community.com/
Research shows that children who receive intensive early intervention services are more likely to have improved long-term outcomes. These services can maximize their learning potential by addressing communication, play, problem behaviours and overall skill development from a very early age. We know, through extensive brain research, that neural plasticity (the brains ability to learn new skills) decreases with age. When children are very young their neural plasticity is high, but as they get older it decreases. When this plasticity decrease, it becomes more difficult to learn new skills.
This is not to say that individuals with autism are not able to learn skills if intervention is not started by a certain age. Their brains, just like everyone else’s, are capable of learning and using new skills and information at any time. Behaviourally speaking, however, as we all age and grow the skills we have learned which are effective and efficient will be more difficult to change due to a longer history of reinforcement. So the earlier we intervene to address an individual’s difficulties with communication, social interactions and problem behaviours the more likely we are to elicit quick and positive change.
This quote from the book “Overcoming Autism” by Lynn Koegel and Claire LaZebnik best reiterates this point:
"I can’t stress strongly enough the importance of diving into action immediately. Every expert in the field agrees that early intervention is essential and critical. The “wait and see” approach is detrimental to your child. Children with autism tend to avoid things that are difficult, and communication is difficult for them, so they avoid situations where they might be expected to communicate. As a result, they become more isolated and withdrawn. So it’s critical that you get a program started right way".