Expert: James Michael Roan - 1/30/2006

Question
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Followup To
Question -
I am a pre-school dance/movement instructor. I am also a former special education teacher (my background is working with children with severe/multiple physical disabilities.) A just-turned-4-year old child has enrolled in my class and according to parent is on the Autism spectrum. I am in need of some suggestions for including this child. She does not seem bothered by the music that is played (loud or soft), nor the number of children in the room (there are 12 in all). My biggest concern is safety - this child will sometimes follow what we are doing, but mostly wants to do her own movements - which include jumping high in the air and landing quite hard on whatever is nearby - the floor or another student! I am concerned both for her safety and the safety of the other children. It is particularly difficult during the tumbling time when I must be spotting each individual student for safety. I am thinking about making a picture schedule that she can follow to help her see what comes next, but I feel that I need a lot more than that. Since this is all new to the mom as well, she hasn't been able to offer any suggestions. She struggles with behavior, listening and safety at home, as well. In class I do follow a "routine" of activities each week, with steps getting only slightly more difficult (the children are aged 2 1/2 to almost 5). The class lasts for an hour. If there is anything you can suggest to point me in the right direction I would certainly appreciate it. From what I understand, she has been "asked to leave" preschools, sports programs, etc in the past (before diagnosis) and I would really like to make this a positive experience for her.

Thank you,
Debbie
Answer -
Hi Debbie;

This is a tough one. In the long run the PECS schedule will help, but a few of the distinguishing features of autism are at work here:

1. Children on the spectrum have an executive dysfunction, which results in inattention and disorganization and is often misdiagnosed as ADHD.

2. Failure to imitate actions, play, and speech sounds is another core deficit in autism. So her ability to attend to what her peers are doing and to naturally copy it will not happen on its own, it must be taught,

It seems clear to me that this little girl needs deep pressure stimulation, which she is getting by crashing into things. Consult the child's OT and make sure someone can deliver this therapy to the child just BEFORE she attends your class. This should work for the short term.

Let me know how and if this works for you.

Kind Regards,
James

Thank you for your response, James.

I have a follow-up because it is my fault for not giving you enough background information. At this point, the child is not receiving ANY services. The mother is not convinced that this is really a long term issue. She still sees it mostly as "my child just doesn't listen and follow directions - but she'll outgrow it. Doctors make mistakes!" (She does have several older children who do not seem to have any disabilities.) So... I do partly see my role as eventually helping the mom to seek services with the local school district, but I haven't known them long enough to have established trust and a good working relationship. Right now, I am hoping to institute little interventions to help make this somewhat successful (and safe). I can also have available a teenager who can come in to the class to assist - although I wouldn't want to place the responsibility of monitoring this child for the whole class period on the shoulders of a young teen.
    The child seems rather fond of an old top hat that is in the classroom - I have thought about letting her wear it as long as she is in a "safe" area (I give all the children in the class instruction on where "safe" areas are for each activity- sometimes it is their own square on the mat, sometimes it is a particular corner of the room where they wait for their turn, etc. EX: "Everyone needs to stay on their own mat while we do leg kicks so we can all be safe." I could easily start calling it the "safe area." I don't usually like to reward a child with something that they might obsess or stim over, but maybe in the short term...?
   Most of these young children do not imitate the movements very well. I do spend a lot of "hands on" time helping them explore movements that might not come naturally. There is also lots of time for "free dance and movement" when I do spend most of the time just making sure they don't all knock in to one another! It's actually a really fun class, but I am exhausted when it's over!
   I appreciate your help!
Debbie  

Answer
Hi Debbie;

It sounds like you are doing a great job! Please keep in mind that early intervention is everything. Every month that goes by, the child's odds of a positive outcome are significantly reduced.

Have a good time. It sounds like the children are having a ball.

Regards,
James