The last article in the Series Treating Autism dealt with the importance of a positive attitude, and how motivation is critical in working with your child. This week, we will discuss how to join into your child’s world, and how to manage the repetitive actions most children with autism perform.
What Are Repetitive Actions?
Repetitive actions are actions performed in a rigid, obsessive manner that is hard to stop. These actions are often performed for minutes to hours at a time and are often abnormal. Examples are spinning plates, rocking, counting, and stacking blocks. These actions are solitary and do not include others. These actions sometimes can be socially unacceptable and are often the main target to be eliminated in most behavioral therapies.
A child who spends hours a day rocking back and forth is performing a repetitive action. It is often difficult for outsiders to understand the appeal of this action. For someone who is not autistic, the idea of rocking back and forth is not understood, because it is hard to imagine the benefit. Rocking is almost a universal symbol of autism, with many afraid to interact or even be near someone who is exhibiting this behavior.
Repetitive actions in themselves are not dangerous; however, they can hinder social skills development. These actions are a problem and need to be eliminated if the child is to enter into a neurotypical environment. Most behavioral therapies work to reduce the behaviors by consequences. A child who rocks may have something took from them or shamed until they stop. This approach does not work for most and often makes the problem worse.
Why Are Repetitive Actions Being Preformed?
Repetitive actions are coping skills designed to help soothe in times of stress. As mentioned in past articles of this series, autistic children are very smart, and often over stimulated. As their senses are heightened, sights, sounds, and even textures are experienced in greater detail by most autistics. This can be painful to some and lead to distress. As most autistic children have problems communicating, they do not know how to tell someone they are in distress. They do not have the social skills to communicate their pain. Instead, they devise coping skills that help distract from the pain. A child who is rocking will do so to reduce their stress and anxiety, which may be continuous.
For example, take a high pitched noise; say nails on a chalkboard. Most find this noise annoying and even may have physical sensations. Imagine this noise being repeated over and over. It would be difficult to ignore. Now, imagine you can tell no one how this noise feels for you and this is a noise you will experience often. What do you do? You find a way to distract yourself from the noise. Maybe it is closing your eyes and imagining your somewhere else. Maybe it is to read a book or look at your phone for hours. No matter what you choose, if asked to quit this action, you would be annoyed. This is how most autistic children feel. Imagine trying to teach a child under these conditions. It would not go well.
How then, do you stop these repetitive actions if they are coping skills for overstimulation? First, overstimulation often decreases with age. Over time, the physical discomfort will decrease, with some sensations becoming neurotypical. The amount of time for this to occur changes from person to person, and is not exact. However, most individuals with autism report over time they feel less sensitive to sensory stimulation. However, the use of repetitive actions over time has become conditioned and will continue even if the purpose for the action is removed. The child will continue to repeat the action; because it is something they have done for years.
The Act of Joining
Your child needs to learn to use other coping skills besides repetitive actions. While this is common sense, the implementation, as least for most behavioral therapies, is not. Most behavioral therapies make the child repeat a new coping skill over and over to replace the repetitive action. The child learns to do the new coping skill but does not learn why. They learn to not get in trouble; they will do as they are told. This is not learning that will help them in the real world. They need to learn the reasons to use the coping skill, and when to use it.
To that end, they need to be taught new coping skills, in a method, they approve of, and will understand. This is where joining comes in. Joining is when you enter into your child’s world and get at their level. Joining involves spending hours of time engaging with your child, by doing the same actions they are.
To make this clear, when joining with your child, you will spend hours with them, doing the very same actions the child is doing. If your child likes to rock back and forth, you will sit with your child and rock back and forth. You will do this daily, for hours a day, for as long as it takes for your child to begin to notice you and begin to communicate.
Most behaviorists would scream at this. They would say, by repeating these actions, you are encouraging your child to use these repetitive actions, and will make the problem worse. However, as your child is most likely already spending hours a day, how much worse can it get? Your child needs to learn to trust you and to know you are someone who is to help them. By repeating these actions, your child will begin to notice you and notice your actions. In time, they will take more notice, and will begin to communicate with you.
Once your child has your attention, then it is time to begin teaching other, appropriate coping skills. At first, this attention may last only a few minutes. Over time attention will increase, giving more time to teach. Eventually, you can begin teaching your child how to communicate as well. This process will provide an environment where your child will feel safe to engage with you and to learn more things. Deep down your child wants to learn and interact, but they need to know they are safe, and that you, the parent, are there for them.
How to Join
When you begin to join with your child, first go to a room of the house that has the least distractions. Clear out space, so there is a good sized area on the floor to sit on. Sit with your child in front of you, far enough, so you and your child have your own space. Make sure your child can see you easily. Next, give them the toy, or item they want to use in their repetitive action and have a copy of one for you. Now, watch your child as they play with the toy or item. Notice their facial expressions, their body language, and their actions. You want to take note, as you will be doing similar actions. Now, begin to do as they do, and continue this for a half hour. Do not speak to your child unless your child looks at you, or points at you. If this happens, compliment your child, and then continue to perform the action. Most of the time you should be quiet, and not speaking to your child. At first, your child may not notice you at all. Over time, though, this will change, and your child will begin to notice you in the room. At this stage, you can begin to teach.
Some days may go well; others may not. Even if your child is more interactive, on some days, they may lapse back into previous behaviors. Do not panic, as this is normal. Your child may not be feeling well, or has had a bad day, and may yet know how to communicate this. Do not push your child, or show disappointment.
Joining takes months and even years in most cases. It is an activity that is critical to the success of your child. Building trust is the most important activity you can have with your child as this trust will be the agent of change for your child.
Teach Others to Join
You will also teach others who are also involved with your child how to join. Everyone who interacts with your child needs to join with them. This will continue the cycle, and teach your child to trust others besides yourself. This is the beginning to teaching your child social interactions. If everyone works to join with your child, then your child will not receive mixed messages, which could be confusing and damage the process.
Some may be resistant to joining, as they will be afraid it will make the situation worse. If you or someone you know has doubts, I encourage you to a video below about joining. This video is from the Autism Treatment Center of America and is part of the Son-Rise Program.
Joining is a powerful technique designed to help you build trust with your child. It is a critical component in the treatment of your child. Joining itself is not difficult; however, it will take time for your child to fully engage with you. Once your child has built trust, you can begin to teach him or her social skills, and how to better interact with others. Joining requires a calming environment free of distractions. Creating this environment will be covered in next week’s article.
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