Expert: Jene Aviram - 3/13/2009

Question
We have brought up our concerns to our 4 year old sons doctor, she reffered him to an audiologist and a rehab center for his motor skills ect. my concern is that the soonest they can see him is the end of april! Everything that I am reading about autism speaks of early detection and intervention. I know that he hasn't been diagnosed but i feel that i should be doing something other than waiting. He is the exact description of a verbal high functioning autistic, although he doesn't have as many skills as some that i have read about. So i guess what i am asking is; is there anything that I can do for him now before i get his offical diagnoses? he failed the m chat but so far that is all me know, thank you very much for your time. Have a great Day
~a very concerned and over whelmed mother

Answer
Destiney,

I can relate to how you feel.  Waiting is the toughest part.  You just want to get moving so that you can be further down the track.  Without a comprehensive evaluation of your son, I can't possibly give you a plan of action.  However, I can give you some ideas that will hopefully give you some direction on how to proceed.

Firstly, read this article "How do you know if your child has autim?"  You can find it at http://www.nlconcepts.com/autism-howdoyouknow.htm
Take a look at the other articles and interviews in the Greatness of autism section.  That will give you some good ideas IF your child is on the spectrum.

Secondly, if your child does have autism, behavior management is very effective.  Children on the autism spectrum are self directed.  They often need external motivators to perform social tasks.  In the same way that people work (task) and get a salary (reward).  Again, I'm not sure what level your child is at, but lets say he wants to drink juice. Perhaps he usually says "juice" or cries to let you know he wants it.  You would hold the juice near him and say "I want juice".  If he doesn't, repeat your command.  As soon as he says "I want juice" praise him very enthusiastically and give him the juice immediately.

Do you want him to stay at the table for a meal?  Let him know that if he stays for 5 minutes, he gets his favorite book.  Purchase one of those Time Timers so that he can visually see how much longer there is.  http://www.nlconcepts.com/autism-timetimer.htm

Does he struggle with transitions?  In other words changing activities.  Make a visual schedule.  It doesn't have to be fancy. You can make simple drawings or take photos.  An example of a visual schedule would be:
1.  Getting dressed
2.  Eating breakfast
3.  Doing a puzzle with mommy
4.  Going to the store
5.  Coming home

Just as you and I like to know what's coming next, this strategy is particularly helpful for kids on the autism spectrum.

Are you trying to get your son to follow along with you in songs, like "When you're happy and you know it clap your hands"  Does he like cookies?  Make sure he sees a cookie next to you before you begin the song.  When you begin "If you're happy..." if he claps his hands, immediately give him a small piece of the cookie (it doesn't have to be the whole one.)  Continue like this.  Soon you will be able to stop using the cookies when your son follows along.

What are your son's strengths?  Focus on those and let him know what a great job he does.  What does your son like?  Lets say he loves dinosaurs, try and get him to interact by relating as much as you can to dinosaurs.  Does your son like music and songs?  I bet he does.  If he is having trouble with something like dressing, make a song and sing it.  Example "I am putting on my shirt, my shirt, my shirt"

Does he have siblings?  Does he know all the members of his family?  His aunts, uncles, cousins?  Take pictures and get small album.  Make a book about your son.  Call it all about.. (whatever his name is).  Your book can go something like the following.  
My name is ...I am 4 years old.  (picture)
I live in a house in (city) (picture)
I live with my mommy, my daddy and my (siblings) .. (picture)
I have an aunt named... (picture)
I have.....
Continue in this fashion.  After you've included the book with his family, I would add one or 2 pages about favorite things such as "I love doing puzzles"  and "Chicken nuggets are my favorite foods"

Does your son know how old he is?  When his birthday is?  These are things you can teach.  How about saying "Thank you"?  This is another skill you can easily teach using a reward system.  YOU ALWAYS WANT YOUR CHILD TO BE SUCCESSFUL WHEN USING THE REWARD SYSTEM.  It's better to make a task too easy, let him get a reward and then make it harder.  Let him be successful a number of times before you make it more difficult.  This way, he will know that he gets a reward and it's worth doing a task.

You want to get your son to interact as much as possible.  Be silly with him, find games that appeal to him.  Sit at the top of your stairs and throw balls down together.  Make sure he interacts though.  One way you can do this is that you hold the balls.  Each time he wants a ball, wait for him to look at you and say "Ball please".  Then give it him and laugh or make a sound together as it goes down the stairs.

You seem pretty confident that your son will get a diagnosis of being on the spectrum.  If he does, your son will get services and you will learn from the teachers and therapists all about behavior management.  Your son is lucky to have such a proactive mom.  Always let him know that you love and accept him for the incredible person he is.

I hope this has been of some help and I wish you luck and success.

Jene Aviram
http://www.nlconcepts.com