Eye contact

Points to note

• Eye contact is a non-verbal communication skill that children with autism do not develop naturally.
• The child may feel very uncomfortable looking directly at someone when speaking or being spoken to. He may not understand how long he should hold his gaze, or is unable to do so in a manner that is natural and comfortable.
• Many children with autism find it very difficult to concentrate and listen to someone speaking while also looking at them. Some students will be able to make eye contact when they speak but not when they are listening. For some children, senses switch in and out so that conversations become fragmented.

What you can do

• Try to link the child’s gaze to something he enjoys. Hold an interesting object near your face to gain his attention. Give lots of praise and/or rewards even if the child makes only momentary eye contact. Tell him “Good looking!”
• It is often more important for the child to learn how to orient his body and give non-verbal signs that he is interested in communicating and listening, for example, facing his body toward the other person.
• The child might become so stressed at having to look at the speaker that he cannot take in what is being said. In this case it will be necessary to judge whether or not it is beneficial for the child to look at the speaker. If the child is able to remain calm and attend to the speaker without making eye contact, it may not be worthwhile pushing this issue. However it would be better to instruct the child that it is preferable to be looking near the speaker and not staring out a window!

Facial expression and body language

Points to note

• When we communicate, we use a range of non-verbal cues in addition to our words, eg. eye contact, gesture and facial expression. A child with autism will have difficulty reading the meaning of these cues. He may misinterpret them. He may also have difficulty using non-verbal communication in a manner that is spontaneous and natural.
• A child with autism may have difficulty with personal space; standing too close or too far away when speaking. He may turn his body away from someone when communicating, preferring to stand side on or head facing down. Some children lean on others like they are a piece of furniture.

What you can do

• It may be useful to teach the meaning of gesture in common scenarios.  For example if a teacher walked into the classroom, put her hands on her hips and frowned, it would mean she is unhappy about something.
• The child will need help learning to pay attention to and correctly interpret facial expression and body language. This can be achieved by helping the child to understand non-verbal communication. Use role play, find pictures in magazines or watch scenes from TV programs to talk about facial expression and body language. Be expressive in your own emotions, facial cues and voice so there are more cues for the child to pick up on.
• The child may always lack a natural ability to read facial expression and use body language. He can, however, be taught how to respond in various situations, such as teaching him the appropriate personal space to give people when conversing. This needs to be done in a way that illustrates the rule for various social situations, otherwise the child will apply one rule rigidly for all situations.
• If the child is anxious or upset, be particularly aware of your facial expressions, tone of voice and use of gesture as this extra information may get in the way of his understanding.
  

Interrupting, repetitive questions and talking too much

Points to note

• A child with autism may ask questions repeatedly because it helps relieve anxiety. Questions about ‘what will happen next’ may be due to anxiety about the future; children with autism have difficulty anticipating what might happen next.
• The child might be reassured by hearing the same response to his question over and over. He may become distressed if the answer differs in any way from what he wants to hear or what he heard the first time.
• For some children, questioning is the only way they know of holding a conversation. They lack the skills to chat naturally.
• A child who talks incessantly may miss the cues from others that it is inappropriate to continue with a conversation that is boring or repetitive. He may also interrupt conversations because he has doesn't know how or when to join in.
• Repetitive questioning may be an attempt at mimicking the conversation of others – “What are you doing?” “What’s that for?”
• The child may go on and on about a topic that he is passionate about. This is because he knows just what to say, however he doesn't understnad that others may not be as fascinated as he is.

What you can do

• Be sensitive to the child’s attempts at communication. Remind yourself that this questioning may be helping him to remain calm. Questioning is often a phase children with autism experience before they develop more meaningful communication.
• Some children love the repetition of asking questions and getting the same answer every time. Vary your answers, while still answering the question. For example, “When do we have Art?” answer “At 11 o’clock,“ “On Tuesday and Thursday,” “After recess,” “Before lunch” etc.
• Move the conversation on while still answering the question. For example, “We have Art at 11am, we are making collages today – what sort of picture will you make?”
• Create a visual timetable for the child. If he can see what will happen each day, he'll feel less anxious and may stop asking questions. You can print out a variety of activity cards by going to the Visual Schedules page or visit www.dotolearn.com (link to external website opens in new window.)
• On a visual timetable, list the times the child is allowed to ask questions. You may need to place a limit on the number of times you will answer the same question. Make a clear rule - "You can ask that question three times only." After that, suggest more appropriate conversation, "We've finished talking about that now, ask me about..."
• You may need to place a limit on the number of times you will answer the same question. Make a clear rule – “You can ask that question three times only.” After that, suggest more appropriate conversation, “Ask me about ….” Give the child a card with a list of alternative questions.
• Use the questioning to motivate the child by telling him that you'll answer his questions when has completed his work.
• If the child constantly interrupts during group time, have an object that is passed around from one speaker to another. Make a clear rule - only the person holding the object may speak.
• The child may need help learning when it is appropriate to join a conversation, ie. when there is a pause or gap. He may need to be taught specific phrases such as “Excuse me.” Teach the child how to pay attention and comment without asking questions, ie. by facing the speaker, making encouraging sounds or nodding.

Language difficulties

Why does this happen?

• A large percentage of children with autism do not acquire verbal language skills; some only use language to communicate their needs.
• Children with high functioning autism may be articulate and have an extensive vocabulary but these skills may mask serious language difficulties. A particular area of difficulty is in the social use of language, known as pragmatics. For example, he may have difficulty initiating and maintaining a conversation or using correct modulation in his voice. His language may sound very rigid or formal. He may talk at people rather than with them.
• The child may also have limited ability to convey and understand the meaning of words, known as semantics. He may interpret language in a very literal and concrete way. He may have difficulty understanding metaphors, sarcasm or jokes because he may not grasp the underlying meaning (inference) or intention in someone’s speech.
• The child might sometimes use words or phrases that seem inappropriate. He might make comments that are very blunt or even rude because he lacks the social awareness of when and to whom such comments would be appropriate.
• Repeating words, phrases or questions is known as echolalia. It is a common characteristic of children with autism. It often indicates the child has poor receptive language skills and has not understood what has been said. Echolalia can be immediate or delayed. It is considered positive as it shows the child is ‘tuned in’ to language.

What you can do

• Use the child’s interests to practise starting and maintaining a conversation.
• Be aware that an extensive vocabulary can mask serious comprehension deficits. You may need to repeat and simplify instructions. Keep your language as precise as possible and avoid abstract concepts. Allow the child time to respond to instructions, then check he has understood.  Use visual schedules or cards to reinforce your message.
• Teach the child a standard phrase to use when he has not understood an instruction.
• Be specific. “In a minute” is an abstract concept to a child with autism that may be interpreted literally. The phrase “It’s getting a bit too noisy in here” carries an implied meaning that you want the class to quieten down. A child with autism may miss the point of this completely.
• Be aware of the language that you use. Ask yourself whether instructions could be interpreted in a way other than intended, such as an instruction that may be misinterpreted as a question. Sarcasm and irony should be avoided.
• Use role play to develop the child’s social language skills. These scenarios can be used to help the child understand when someone is joking or teasing, how to initiate a conversation and how to respond to the emotions of other people.
• Discuss some common metaphors and explain what they mean. Eg. “Pull your socks up!” and “I’m feeling a bit under the weather today.”
• Sign language may assist some children, even those with mildly delayed language skills. For example, in a noisy classroom, you notice the child across the room in difficulty and becoming frustrated. You could say, “Do you need help?” while signing ‘help’ to reinforce your question. Speech pathologists can provide examples of useful signs.

Literal interpretation of language

Why does this happen?

• Children with autism have language difficulties that cause them to interpret what others say in a very literal way.
• Confusion can arise where indirect and polite forms of speech are used. Instructions may be treated as questions when they are phrased in certain ways, for example, “Can you tidy your desk?” The child may answer the question but does not realise that you are actually expecting him to do the requested action. A teacher who does not understand the student's difficulties may think the child is being disrespectful or rude.
• This confusion can be attributed to difficulty interpreting the motivations and intentions of the speaker. Children with autism have trouble understanding what others think and feel.
• Figures of speech, humour and sarcasm may also cause problems. The child may be ridiculed by his peers when figures or speech are interpreted literally.

What you can do

• Monitor your language; try to be aware of phrases you are using that could be interpreted in more than one way. A child with autism may miss the intended meaning, even if it seems obvious to the neuro-typical mind.
• Be specific and state what you want, rather than what you don’t want.
• Phrase your questions as a directive, eg. instead of saying "Can you pass the textas?" say "Pass the textas"
• Teach the child the meanings of some commonly-used phrases and figures of speech.
  “Pull your socks up!”
  “Stretch your legs.”
  “Get a wriggle on.”
  “In a minute.”
  “Under the weather.”
  “Cat’s got your tongue.”
  “Drop everything.”
  “Catch you soon.”

Not responding to instructions

“William doesn’t respond to group instructions because he doesn’t realise that he is part of the group."

Why does this happen?

• Most children with autism have poor receptive language skills; they interpret language literally and have difficulty with long verbal instructions.
• Some children have difficulty with group instructions. Possibly they do not think of themselves as part of the group, so they don’t realise the instruction also applies to them.
• However some children will respond better to group instructions. Those that recognise group instructions tend to be the type to adhere strictly to rules. They will rigidly follow these rules in preference to being singled out.
• Auditory processing may take longer in children with autism. They may need more time to respond to an instruction.
• The child may have an overriding desire to do what he wants to do, not what he is told to do. This compulsive behaviour can make it hard for him to stop what he is doing. The child may feel the need to control his environment as a means of making the world more predictable, thus lessening anxiety brought on by uncertainty.
• The child may be easily distracted and irritated by even a minor level of background noise. This makes it very difficult for them to interpret instructions and distinguish your speech from other sounds. Children with autism may only be able to attend to only one stimulus at a time, ie. visual, auditory or tactile.
• The child may follow an instruction one day, then won't respond the next. This can be really frustrating for teachers; it can be caused by certain environmental cues. For example, you are holding up a student's project and you ask the class to start working on the project. The child with autism responds to the visual cue. If you are not holding a visual cue next time you give the instruction, the child with autism may not respond.

What you can do

• Gain the child's attention. Address the child by name even when addressing the group as a whole. This should gain his attention and help him understand that the instruction is intended for him as well as others in the group. If you have a classroom aide, have him/her repeat the instruction to the child individually.
• Assess whether the child responds to group instructions. If he is non-compliant when you make an individual request, it might be better to address the child with autism as if you were giving a whole-class instruction.
• Give the child sufficient time to respond to an instruction (perhaps ten seconds) before repeating it.
• Slow down your speech and emphasise the important words.
• Use clear, precise instructions. Give only one instruction at a time. Auditory processing difficulties may result in the child missing parts of the instruction. Instead of hearing, “Don’t slam the door!” he may hear “Slam the door!” Try saying, “Child’s name, shut the door quietly please.”
• Approach the child and try to gain his attention and eye contact before giving an instruction. If the child doesn't mind being touched, you could gain his attention by touching his arm or hand.
• Keep classroom noise to a tolderable level. This will reduce stress levels and maximise the child's ability to concentrate and listen to instructions. The child's ability to prcess language will diminish or fluctuate when he is stressed.
• Use visual cues to maximise the child’s ability to fully understand instructions.
• Sign language can be helpful to reinforce verbal instructions. You might sign ‘sit down’ while you are reading a story, as a subtle reminder to the child with autism to remain seated in a group.
• Make sure the instruction is a directive, not a question. Instead of saying, "Can you pass the textas?" say "Pass the textas." This does not mean that you have to use an overly firm voice or that you cannot give the child choices.

Visual schedules

What is a visual schedule?

Schedules are an important teaching tool for students with autism because they have:

• Limited understanding of the concept of time, ie. knowing what is happening or will happen and then sequencing, predicting and organising the order of events.
• Difficulty with communication. This includes difficulty understanding verbal explanations of what will happen at certain times during the day.
• Rigidity and need for sameness. Changes can create considerable stress for students with autism. One way to reduce stress and increase opportunities for success is to use schedules.

A visual schedule can increase the child’s independence and ability to understand classroom routine. You may find the child becomes less dependent on teaching staff and verbal instructions, along with a reduction in difficult behaviour and repetitive questions.

Types of Visual Schedules

• Yearly diaries
• Term diaries
• Monthly calendars
• Weekly calendars or timetables
• Schedules of one hour, 10 minutes or less
• General daily classroom schedule with activities and individual tasks
• Individual work skill schedule
• Sequence charts / schedule of daily routines

Remember Visuals
A variety of visuals are used in schedules. Remember most students with autism spectrum disorder are visual learners, so where possible use pictures or written words in conjunction with verbal communication.

You can use a computer program such as Boardmaker™ to make your visual schedule or download and print the pictures provided on this site (see links below).

A range of formats can be used. This includes posters, blackboard / whiteboard, diary, strips, small photo albums, business card holders, cardboard strips or books.

Behaviour
Schedules can be the cornerstone of management practices for children with challenging behaviours. Specific behavioural deficits can be managed using schedules. For example, to clarify expectations, set limits, reduce negative teacher attention for undesired behaviour. Schedules can indicate that a preferred activity will follow a non-preferred activity.

Communication
Schedules can be used in a variety of ways to develop language and aid comprehension depending upon the individual student’s needs. For students with limited verbal language, schedules can provide an opportunity to interact and communicate.

Mathematics
Schedules are excellent for teaching time, numbers, days of the week, months and year. These are all important life skills.

Social Skills
The playground can be extremely challenging for students with autism; many find this an extremely overwhelming experience. Using a schedule of ‘activities to do in the playground’ can considerably reduce anxiety. Provide a range of appropriate activities (written word, Compic, photos etc. depending upon student’s needs). At first you may need to select the order.

The above text adapted from “Making It A Success” by Sue Larkey
See Recommended Reading for details.

A great little site that explains the use of visual supports and social stories can be found at
www.angelfire.com/ky/touristinfo/index5.html (link to external site opens in new window.)

View images on this site.

A large range of images can also be found at www.dotolearn.com (link to external website opens in new window.)