Friday, March 18, 2016

My Little Cricket’s Delay: JASPER Mommy and Me 6: Routines, Communicative Gestures & Language

Today was a big pile of subject matter; two topics in fact. Since three of the four moms in the group, myself included, are all newly diagnosed we have a ton of questions. The piolet class, the one before us, were all veteran moms, moms that had their child diagnosed a year or two before introducing JASPER and there was less handholding than I think this class needs. So with a mountain of content to get through the director had to go quickly through the material and save questions if there was time at the end.

Routine is the cornerstone of how JASPER works. Without the routine the other wonderful aspects of joint attention, language, gestures, and increasing play level wouldn’t be possible. Play Routines, as defined by the JASPER clinic, are a repeatable sequence of how to play with a toy; which promotes learning of language, play skills, and engagement with communicative partners. By building a routine a child knows what to expect and knows the next step to take. From this comfortable base a child can form new diverse play ideas, can increase the level of play they are at, and because they aren’t focusing so much on the play they are able to extend joint attention and build social communication skills. A high quality routine would target a child’s language level, would increase their joint attention, would use positive affect and would be expanding into new areas. Once several different play routines are established it would be a goal to link two or more together creating more diverse and child lead play.

When choosing toys for a routine it is important to choose open ended toys (not a simple cause and effect toy). Examples of toys that would be good are puppets, blocks, magnatiles, food and people. When building a routine that has several steps the base is something that comes easily to the child, generally at one play level below what your child’s current play level is at. For My Little Crickets routine he makes things out of magnatiles. We build houses, we build roads, we build rockets and towers. The possibilities are endless but more importantly he is completely comfortable with building and because it is one step below his comfortable level it is considered a mastered level. . As we add layers in the routine the demands become greater. So as you move into more difficult areas turns between the therapist and the child become less. For instance we may spend 5 or 6 turns building a house, but in the next step where the people knock to go into the house there may only be 4 turns. As the routine gets more advanced and the demands become higher in the child’s play level by the time we get to the top there are typically only 2 turns between child and therapist. And the routine starts again.

The next subject we discussed was Communicative Gestures & Language.

Requesting is the easiest gesture and it communicates a want or a need by pointing, reaching or giving.

Going a step further is adding in the joint attention piece. So the child would share or maintain social interaction by using the gesture and a coordinated joint look at the other person. Joint attention is more difficult for ASD kids so it is important to closely watch your child and hugely celebrate tiny gestures or subtle beginning gestures.

Language is another core piece that JASPER focuses on. My Little Cricket doesn’t have many spontaneous words but he does babble and speak with jargon quite a bit. I was told to fill in the blanks when he starts to babble. By modeling the correct words he knows they what he could say on his turn. Once my Little Cricket is using some words and if he is comfortable in the routine and regulated then it is important to sometimes model the next level by adding another word. For instance if we are playing and he is consistently saying ‘block’, then on my turn I can model ‘block on’.

Lastly I wanted to talk quickly about the thoughts that founder of JASPER shared on gestures in ASD children. A very important part of communication happens way before a child says their first word. It is the development of gestures. There is a strong link between gestures and speech in communication. Gestures are generally formed in typical children by mimicking and copying the people around them. Generally gestures are used before spoken language but children with Autism often miss the concept of gestures all together because they often have difficulty with imitation. Researchers have studied the imitation abilities of children with autism, and the effect this has on other areas of development. They have found that:

- their ability to imitate gestures and body movements often predicts their language outcomes
- their ability to imitate actions with objects is related to the development of their play skills
- their difficulty with imitating other children’s actions affects their peer play
- they need to develop some imitation skills before they are able to acquire joint attention

This is why learning gestures, filling in this skill gap, with autistic children is so important. Without gestures, without imitation, children with autism won’t reach the highest level of their potential. Lastly the doctor left us with this thought; that she worries most about the future of autistic children who have little to no use of gestures, who don’t socially imitate, and who have little to no facial animation and affect.

My Little Cricket is very friendly, he is social, he uses gestures like pointing, waving bye bye, a beckoning come here gesture and a hand up wait for me gesture. He uses them often. Although his imitation was slow to start he has been making great strides in imitating so much more.

If I have learned anything over the past two months it has been to count the blessings. There is so much to be thankful for. So much to celebrate. Sure it isn’t perfect, but then nothing really ever is.

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