I’m usually face-to-face with parents when I offer advice. As we sit in my office brainstorming together, we talk about what to do about an autistic child’s strengths and weaknesses, successes and failures. Drawing from these meetings, here are some issues facing parents of autistic children, and advice on how you can handle them.

First off, you’ll want to talk to your child’s pediatrician if you suspect that he is not developing normally. He may be exhibiting such autistic behaviors like sensory sensitivities; social withdrawal; avoidance of eye contact; a preoccupation with routines; repetitive arm, hand or finger movements; self-injurious and wild behavior; or reversal of pronouns.

It is important to act soon. Treatment efforts should target three areas of difficulty: playing, communicating and socializing. The sooner you can create home programs that fit your child’s special needs, the better his chances of coping with autism.

Playing

Playing with your baby or toddler is a window of opportunity for both of you. Through play, you will be able to introduce your autistic child to the all-important communications that make us social beings.

Note any objects, toys, equipment or household items to which he seems especially drawn. If he shows some minimal, passing interest in a ball, begin by exploring the roundness of the ball, rolling it, cradling it, tossing it. Then roll it to him to see whether he will pick it up, hold it, explore its shape or toss it. Ask him to roll it away; maybe he’ll even roll it to you. Start a game by saying, “Go away ball; come back ball.”

If he stares at sunlight streaming through a window, show him how you can create different effects by partially closing the blinds or drawing the curtains. Or get some colored cellophane for him to play with as he gazes at the light.

If he’s interested in the sound of machines whirring, let him turn them on and off, with your supervision, of course. Supply him with battery-operated toys that he can manipulate in this way. Talk to him as he plays: “Now you’re turning it off; now you’re turning it on.”

Gradually add other items to the pile to which he’s already responded favorably. If he rejects any or all of these, ask him to select which new items he likes and which he doesn’t.

If you’re sitting together among playthings and he takes something you’re holding, don’t protest; ask him to give you a toy in return. Tell him you need it so the two of you can play together. Then offer to give it back. Say, “Now I’m taking the toy; now I’m giving it back.” If he turns away or stares straight ahead, tell him that you will ask to play with him again tomorrow.

Don’t be afraid to use a “trial-and-error” approach with your child. This is the only way you will hit upon something that works. Be careful not to give up on an activity too soon. He may be testing the effects of his nonresponsive behavior on you.

Communicating

When your child begins to enjoy playing, he is primed for the beginnings of conversation. But you may have to communicate, at first, through gesture, facial expressions, childhood games, drawing or storytelling.

There are many nonverbal cues you can use to communicate with him— for example, shrugging when you aren’t sure of something, beckoning with your arm when you wish him to precede or accompany you, motioning for him to stop what he’s doing or where he’s going by holding your hand flat out in front of you. If he puts his hands over his ears to block loud or offensive noises, do the same to show him that you understand the noise is offensive. Join him when he shakes his head no or nods yes.

Hands on hips to indicate good humor when he has done something silly, mischievous or against family rules expresses your feelings in a safe way. Playfully use vocal exclamations as a bridge to language, such as “huh?” “aha!” “oh,” “oops,” or “wow.” He’ll be able to attend to one-word communications more than he will to whole sentences.

Invent hugging games to play with him. Try telling him softly, “It’s time for a little hug now,” or create a song inviting him to hug you or alerting him that you are about to hug him.

You might try variations on hide-and-seek with your little one. Hide an object, not yourself at first, and not something to which he is particularly attached lest he become frustrated and refuse to play. Hide a cookie or other snack under a towel or hide it, ostentatiously, behind your back. Leave a portion of the hidden object showing so that the game proceeds easily. Then hide
the whole object.

He might invent words for the fun of it. If his sounds approximate a real word, say it. Later, say it in a sentence, but don’t comment that it is not a real word. He probably knows that, but if not, he will figure it out for himself.

Drawing with your child can be an inroad to increased communication. If he draws something recognizable, draw something in response, but let the drawing sit on the table until he’s ready to notice it. As he gets used to your presence, try guessing out loud what he’s depicting. If he becomes angry at wrong guesses, encourage him to tell you what he’s drawn: “Oops, I was wrong. So tell me, please, what it is.”

Socializing

Getting a conversation going with your autistic child, in much the way you’d talk to any child, is a great boon to his language development and his self-esteem. The two of you speaking companionably will make him feel like a regular kid. When he learns to socialize with you, he’ll be motivated to socialize with his siblings, his teacher, and eventually, a few of his peers.

Older autists likely have developed a good grasp of language. A youngster of 9 or 10 might focus, though, on one or two topics to the exclusion of everything else. Don’t be afraid that he will develop into a “little professor.” Gathering facts is his way of dealing with the world around him. Enjoy conversations with him on what he’s learned about dinosaurs, superheroes or baseball statistics.

You may be told by teachers, friends, neighbors, relatives or experts to discourage him from indulging in his favorite topics or diversions. This is misguided. Though his teacher will undoubtedly ask him to leave his private world to attend to learning, you, as his parent, can allow him his world. What’s more, he won’t attend to you and what you have to say if you don’t attend to him.

If he resists such a plan, realizing that you are trying to lead him into a shared world, assure him that you are truly interested in his thoughts and ideas, but that sometimes it’s his turn to listen to you for a few minutes, or that it’s time, now, to talk together. Your ultimate aim will be to get a discussion going in which you share ideas with your child.

Storytelling is a good way to ease communication with your young autist. Ask if he’d like you to tell him a story. Follow up by writing or typing the story for him to look at and possibly to read. Then read it with him, and if he will permit it, discuss it.

Don’t give up if he rejects you after an apparent breakthrough. He’s still getting accustomed to one-to-oneness. Or he’s asserting his right to choose what you do together. You can say, “Okay, this is enough for today; but tomorrow’s another day, and I want you to try with me again.”

An autistic child of 10 or older might repeat words that you soon discover belong to a single category. This is an important cognitive achievement. It means a child has begun to classify objects spontaneously.

If he is listing animals, you can list plants; if he’s grouping his toy animals in a pile, you can go to the garden and pick some flowers. He’ll benefit from knowing that you appreciate what he has taught himself.

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