Atypical Teaching Strategies Using Mental Prompts for Individuals With Autism

This page is devoted to my personal opinions and strategies for working with a subgroup of individuals — primarily with severe regressive autism — who are nonverbal and demonstrate significant motor and sensory impairments. I've also found some of these strategies effective with those with some verbal capability who have difficulty accessing their words.

What do I do when I encounter a child with these enormous gifts and obvious challenges? I establish trust. I tell them that I know of their competence and that I am willing to serve. I view myself as a bridge to help them understand and utilize our communication system. At the same time, I acknowledge them as my teachers. Most importantly, I try to keep my own energy, calm, peaceful, yet assertive to insure they feel safe and protected, as they appear to be very sensitive to my energy.

When teaching, I attempt to set a dominant rhythm, encourage the kids to stop self-stimulatory behaviors, and deliberately send mental prompts. I do this to limit the focus of the child and keep him on track. I feel it improves the student's ability to categorize, organize and access information. If the child is facing me, I send the mental prompt in mirror image. This is especially true when I am using word cards. I also say the answer sub-vocally. I speculate that a type of entrainment of brain wave frequency is occurring during my interactions. There is a sense of trust established. The children do not react to things that might normally bother them, but rather just go with the flow. I speculate that it is easier to entrain brain wave frequency when the discrepancy is not too great. I believe these children are vibrating at a high frequency. I speculate that those they are able to initially join with are vibrating higher than normal also. After initial entrainment occurs, I attempt to lower my own frequency by becoming present or aware, in hopes that they will lower their own frequency to match mine. Over time, I have noticed that the individual can respond to individuals he normally would not relate to. I speculate that this method is at least partially responsible for increased receptive language skills.

To see if a connection has been made, I might show the child two picture or word cards and see if he will choose the one I ask for. This may be a child who had not shown any prior ability to read, or even negligible receptive language skills. If so, and the connection was successful, I think of the word card I want and speak it sub-vocally. When facing students, remember that I visualize in mirror image. When possible, I prefer working with students from behind so I am moving in unison with them.

This is also true when I engage a child in facilitated writing or drawing, as we are moving in tandem using a typical right to left progression. Unlike hand over hand, I hold the writing or drawing utensil in my hand and instruct the child to copy or draw a particular shape or letter. When working, I often start the child at the top and stop when a switch in direction is needed. I often also stop him at the bottom, as many of the children obviously have difficulty starting, switching and stopping movement. If a variety of individuals are working on assisted writing or drawing, I would suggest they all use the same top to bottom, left to right progression, unless a student signals a different precedent.

I always say the letter, shape, or object at the same time I'm sending the image and/or sub-vocalizing. If I am facing the child, images are sent in mirror image. I like to remove mental prompts as receptive language skills improve, explaining to the individual what I am trying to do and why. This is tricky in a group setting where the students' needs for prompts vary.

I find that giving the student a limited choice of possible responses and then slowly expanding the field gives him a vehicle to demonstrate his competence. It puts him on track and increases his ability to filter, organize and categorize information on its own. Stimulus response-type instruction seems to increases the fluidity as opposed to inactive listening.

In direct contrast to teaching typical children or verbal, concrete-thinking autistic children, I tend to work with individuals with this type of autism starting with the abstract, moving to the representational and then to the concrete. I meet them in areas of abstract thought (words). Once they appear to be able to read a word by selecting it from a field of choices, I would then have them select the word when the function was given. (i.e. what do you color with?) Next I might ask them "who/what/where/when/why" questions and again have them select the correct word card — not only to check comprehension but also to narrow their focus and hopefully help them form mental categories. For example, if I ask a "who" question, hopefully they begin to process that I am looking for a person. If I ask a "where" question, then I am looking for a place. "What" would signal an object. "What" are they doing would signal a verb. If a child has difficulty labeling, then I often start with actions, because there are less of them and their meaning is potent: i.e. eat, drink, play, jump.

The word needs to be linked with a picture and the picture (representational) with the object (concrete). It has been my experience that students are often able to pick out the word "glue" or the picture of a bottle of glue before they can pick out the actual glue bottle from a field of choices. I wonder if this, too, can be explained by vibration frequency and/or image consistency. Does a two-dimensional image of the word "glue" vibrate at a higher frequency than its three-dimensional counterpart? Does the student perceive three-dimensional objects as we do? Is it possible that a three-dimensional object vibrates so slowly that it is not being perceived in the same way by sender and receiver? Or is it simply that actual objects vary so much in terms of attributes?

Words are constant, as are many communication pictures used in the classroom. Whatever the reason when teaching, I believe the individual should be encouraged to demonstrate concrete correlation and awareness. Integration, correlation, transfer, and backward chaining of underlying skills needs to occur. Although the lights (abstract) are on in the attic, the foundation (concrete) is often very weak. In contrast, when I am joining for them to give me information and increase my level of awareness of the spiritual side of life, I just let it flow, as they are the ones teaching me. I believe the two can coexist if everyone would be honest with the student, the parent, and the community.

I facilitate gross and fine motor movements in all areas and slowly remove prompts, using backward chaining — whether it be buttoning, tying a shoe, throwing a basketball, cutting food, selecting a correct response, drawing, writing or typing.

I am open and aware of the influence I can have over their communications. Either intentionally or not, I supplement this form of communication with PECS (Picture Exchange Communication System). PECS encourages spontaneity and is less dependent on a connection with me. PECS also serves as a preliminary step to augmentative communication devices and programs. Adept students do not need their partner to be within certain proximity to use it. However, PECS restricts the student's higher-level communications and astounding demonstrations of intelligence or access to it.

Often when using PECS, I have the child type the word on the picture and hand me the communication device. Once they have demonstrated that they understand that the word, picture and object are the same thing, I let them type their request on a voice output communication device. If they are not using a voice output device, I have them hand me the communicator. At this point, they may also switch to augmentative communication programs such as speaking dynamically. I have worked with a few who demonstrate this level of independent competence; with no agent present, they demonstrate similar language deficits as moderately functioning verbal individuals with autism. Though these particular students were nonverbal and had significant motor impairments, they appeared to have less difficulty initiating.

It has been said that individuals with autism use one sensory channel at a time. It has also been said that there is a delay between visual and auditory processing. I would like to add that I have noticed that some individuals demonstrate disconnected sensory channels. Often they will lose their accuracy in selecting a correct response if they have to get up and move. Giving a visual prompt, picture, sign or gesture usually remedies the problem, but it does not explain the break. Is it going from listening to moving that cause the thought disruption? Or is it because they have lost their connection with me?

Of course, then there was the nonverbal student who never looked at the table to scan the array of answers — not even a quick peripheral glance, yet, his selection of responses was invariably correct! It appeared as if he were seeing and controlling his body from outside himself.

Some of my more severely affected students were not be able to match an object presented visually with an object they could touch but not see. For example, I put a crayon, bottle of glue, scissors and a ball in a bag. Then I showed a student a crayon and asked him to reach in the bag and find the same. He appeared unable to do it. I then put one of the objects in his hand, and he had no difficulty reaching in the bag to find the same object. He was successful at tactile to tactile, but not visual to tactile. Other students who showed the same difficulty eventually picked it up with practice, but he continued to have difficulty.

When students are engaged in self-stimulation, such as hand flapping, I encourage them to stop when we are in the process of direct instruction and/or joining, because it appears to interfere with our connection. Tapping the child alternately on the right and left side of the body to establish a rhythm seems to calm the student down and cut down on his need to self-stimulate. When not involved in direct instruction, I let them re-engage in self-stimulatory activities if they are not dangerous. I attempt to replace dangerous ones rather than fade them.

Many of the children appear to lack an internal rhythm. I would suggest that parents keep babies and young children very close to them so the child can feel the heartbeat and rhythm of the mother. I have noticed that by alternately tapping the right and left hand, shoulder, or arm calms the kids down and lessens self- stimulatory behavior, as many appear to be used to provide self regulation or rhythm. I might also have them listen to ocean waves to help attune them them to the rhythm of the earth. As they matured, I would encourage them to participate in group meditation, holding hands with calm individuals with even breathing. Listening to binaural beats, and musical entrainment CD's, new age music, and nature sounds all seem to have a positive effect.

I allow ample time for spinning, swinging or jumping on a trampoline and have found that saturation lessens the need for vestibular input over time. Many of my students liked rhythmic pressure to the sides or front and back of their heads. It has been particularly helpful for students who are self-abusive, anxious, or exhibit auditory defensiveness. I believe that brushing, deep-pressure, massage, joint compressions, meditation, reiki and reflexology all have their place in helping the child feel more comfortable in his body.

To summarize:

Attitude:

1) Open your heart and join. Keep your emotions and energy calm, open, and loving.

Truly love them and feel blessed in their company.

2) Approach with respect. Assume competency. Acknowledge intelligence.

3) Make sure they are comfortable. Be aware of internal and external sensory irritants

and attempt to alleviate them. (lights, sounds, smells, erratic interfering thoughts)

4) Provide positive sensory experiences. (deep pressure, massage, spinning, swinging)

5) Realize that many self-stimulatory behaviors and movements are used to get their bodies, sensory systems,

and brains to function. Help them establish an internal rhythm.

6) Understand and organized body leads to an organized mind. learning appropriate and varied

movement patterns enhances all areas of function.

7) Let those who chose to use you as a tool. It is often a step along the way.

8) Understand some individuals with severe autism benefit from an agent with a strong rhythm to

maintain their attention and override other interfering stimuli. Use this strong rhythm to deter

interfering self -stimulatory behavior during direct instruction.

9) Accept the fact that a form of telepathy or joined or entangled energy is occurring.

10) Empower them! Promote independence with dignity! Accept the unexpected!

Strategies:

1) Meet each child at his level.

2) Provide visual strategies, motoring, and mental prompts as needed to insure errorless

teaching. Remove as needed using backward chaining techniques.

3) Teach through out the day. Include children in all conversations. Provide slow relaxed visual and

auditory input throughout all activities.

4) Narrow focus. Start with a field of two and broaden.

5) Use sentence closure techniques for non verbal or those with limited verbal capability.

6) Teach categories to help them develop an internal filing cabinet that limits choices.

7) Provide motivating activities specific to each child to increase initiations.

8) Make sure the child correlates the abstract (word, sign) representational (picture) concrete (object).

Remember, With severe students with a propensity toward hyperlexia and or telepathic prompts the word

may be learned first.

9) Teach simple understanding of parts of speech by having the children answer simple "wh" questions about a

sentence in hopes of internally limiting possible responses, thus promoting easier access.

10) Repetition is key, particularly if movement is involved. Yet, be willing to move on if the children indicate

the need.