Expert: Trey McGowan - 9/11/2007

Question
Hi,
My son is 5 yrs old and he has been diagnosed with Autism PDD. A little history about my son. He had severe acid reflux issues as a baby started at 7-8 months and lasted for about 3 yrs. He had very good eye contact right from the begining. He loved giving/receiving hugs. Liked playing with other kids though his way of playing was to watch other kids play and just jump around them flapping his hands. He loved being with those kids and followed them but couldn't initiate a conversation or an activity. He was really good at numbers and colors and identifying shapes etc. But when it came to expressive speech, he couldn't express himself like a normal child. His receptive ability also is not very good. If you talk to him (only talking. Not the kind of talking you might do while you are playing say a game with him but just sit on the sofa and talk to me about what you did in school today kind of talk) he will look at you for 5-6 seconds and then start staring in space.
My son has low muscle tone in his upper body. I have read many stories of kids where the parents say that their child was doing great till 17-18 months. That their child reached all the milestones till 17-18 and then his progress deteiorated. With my son, that was not the case. My son started to crawl late, walked late (17-18 months). The other children that I just mentioned showed good eye contact til 17-18 and then after that they seemed to have lost that eye contact. In my son's case he never lost good eye contact, except when you talked with him directly. He's a pretty sharp kid and remembers streets and directions to the local mall (he's 5) but he just doesn't understand a simple story. I bet he can tell you a 15-20 line story about something but he just doesn't understand the concepts in the story. His receptive ability when it comes to understanding concepts in a story is just not there. You teach him how to count numbers or add 5+2 and he can do that. Something that is visual and is not open ended, he can do very well. But understanding a story or understanding open ended questions, he fails miserably.
Does your child seem similar to my son? What have you done to improve his receptive skills? Please help.
Thank you...
Regards...

Answer
Hello there, Raj!

Everything that you're saying sounds like a pretty typical expression of autism. I know that may not be saying much, considering the different expressions, but you don't need to panic over the situation. These are things that can hopefully be worked with.

You ask about my own child. I ask you 'which one?'. ... don't worry. I'm not going to leave the answer at that. ;)  I've got three, with varying degrees. Of all of them, my daughter is the best at eye contact. She had early intervention, though. And when I say 'best', she's not as good as the average person. Eye contact is simply too overwhelming a lot of the time. She is also the best at speaking and communication, again because of a speech therapist, while the other two are non-verbal (the eldest, in particular, is seven years old and hasn't spoken a word). This is why I say that it is *crucial* to get speech therapy so often. Not all children are going to have the lack of verbal skills, but if they do, getting help with them is best.

As for getting better at the eye contact, as I said above, this is a difficult one to work with. Eye contact is very hard for people with autism because of the overwhelming level of emotion. One thing you can try to do is to explain to your child to try and at least glance toward the person's eyes now and then to indicate interest and focus. If he can't look there for long, at least have him returning to it now and again. By conscientiously keeping that up, he'll hopefully keep in mind that eye contact is equal to attention. Staring for long period at eyes, especially if he has to answer a question, is difficult because it takes *all* his focus. It's a balance point, basically: while he needs to learn to be at least glancing that way when you're talking to him, you need to be patient with the fact that it's something that many autistic children will never learn how to do perfectly.

Other ways of improving receptive ability will probably best come from a specialist. There's too many possibilities, and like with all people, some work better than others when it comes to individuals. Remember that for autistic children, things like 'imaginary' can be very difficult to process. As can Theory Of Mind (the fact that there are other ways of thinking than your own), and Metathinking ('thinking about thinking'). They are simple, straightforward, and direct. They think in concrete physical and immediate terms. See if you can work your teaching around those things, and teach him little by little how to bend the concept to his thinking, if not the other way around. I know, it sounds like I might be asking a lot. Hopefully, though, it'll help with the issues. With my children, I had the advantage of 'thinking similarly', so I could try and work teaching around the more specific things. With your own self, it may take a bit of time to consider their 'method of thinking'.

http://www.springerlink.com/index/P3U026N080435434.pdf
This is a PDF, rather than an HTML page, but it's a writeup for teaching strategies for the autistic child. Maybe you can find some hints in there to improve the skills.

http://www.cdrcp.com/aut_teachingtips.html
An article on teaching the autistic child from the famous Temple Grandin. A very good look into the 'how to think' mindset.

Hopefully I was able to help! If there's further detail either given or needed, or you want to ask more (or another), feel free to follow up! Hopefully I was able to give some good info.

Trey