Using Play To Engage Preschoolers With Autism Spectrum Disorders

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Using Play To Engage Preschoolers With Autism
Spectrum Disorders

• Lisa Zenni
• Speech Language Pathologist
• Harrison Intensive Rost Medically Fragile
  Preschool

Bethany Soundappan Speech Language
Pathologist Whitaker Intensive Toddler Preschool
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Agenda

• What is DIR?
• Floortime and how it relates to DIR
• Six developmental stages (video case studies)
• Summary of floortime approach

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What is DIR?

• Developmental - 6 basic stages of child
  development that lead to 3 advanced stages of
  development
• Individual-difference - the unique way of how a
  child processes information
• Relationship-based how a child relates to his
  learning environment and uses that information
  for developmental progress

• Method of analysis that enables parents,
  educators and clinicians to assess and plan
  treatment for individual children with Autism
  Spectrum Disorder (ASD)
• Assess how emotions lead to symbolic thinking and
  intelligence

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Floortime and how it relates to DIR

• A component of a comprehensive DIR-based
  intervention program for children
• It is a specific technique as well as general
  philosophy that characterizes all daily
  interactions with a child
• Goals
• "Follow the child's lead" to harness the child's
  natural interest to bring the child into a shared
  world.
• It is not about commenting or just imitating but
  more about interacting at the child's level of
  interest

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Six Basic Developmental Stages

• Stage 1 Regulation and Interest in the World
  (Shared Attention)
• Stage 2 Engaging and Relating
• Stage 3 Intentionality Two-Way Communication
• Stage 4 Social Problem Solving, Mood Regulation
  and Formation of a Sense of Self
• Stage 5 Creating Symbols, and Using Words and
  Ideas
• Stage 6 Emotional Thinking, Logic and a Sense of
  Reality

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Developmental Stage 1 Regulation and Interest in
the World (Shared Attention)

• Observe the child at free play
• Assess the child's interests, sensory and motor
  planning profile
• Develop a list of Comfort zone activities
• Obtain shared attention by imitating the child's
  behavior and entering 'their' world, whether its
  appropriate or not
• Video Clip Example

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Comfort Zone Activities

• Lining up blocks, trains, cars, trucks, dolls
• Playing on the computer
• Turning on and off lights
• Flipping through books
• Water play/flushing toilets/watching water
• Holding objects in his/her hands

• Watching blinds/edges/spinning things
• Humming, making noises
• Licking, mouthing, smelling
• Deep pressure/spinning /swinging
• Watching Barney, Blues Clues videos
• Flapping hands

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Developmental Stage 2 Engaging Relating

• Enter the child's world and help him enter into a
  shared world with others.
• Techniques of engagement
• Following child's lead
• Playful obstruction
• Video Clip Example

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Developmental Stage 3 Intentionality Two-way
Communication

• Get the child to become a truly purposeful
  partner by opening and closing many circles of
  communication
• Mastering 2 way communication prevents a child
  from being repetitive
• Each new circle should be somewhat different from
  the prior circle (i.e. Tickling child)
• Video Clip Example

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Developmental Stage 4 Social Problem Solving,
Mood Regulation and Formation of a Sense of Self
Social Problem Solving

• Help the child take the initiative while using
  2-way communication to problem solve (ie. child
  wanting to go outside)
• Create obstacles around the childs interests
• Initiative is often the missing piece in children
  with ASD
• Progress is built on emotional interactions

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Developmental Stage 4 Social Problem Solving,
Mood Regulation and Formation of a Sense of Self
Mood Regulation

• At this stage, children learn to modulate intense
  feelings through emotional signaling (ie. hungry
  child)
• Children with ASD have difficulty mastering this
  stage
• difficulty with motor planning
• difficulty perceiving vocal or facial expressions
  
• caregivers that dont signal back or are intrusive

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Developmental Stage 4 Social Problem Solving,
Mood Regulation and Formation of a Sense of Self
Forming a Sense of Self

• Self definition
• Understanding of how physical world works
• Develop understanding of you and I

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Developmental Stage 5 Creating Symbols, and
using words and ideas

• Follow child's lead
• Challenge and elaborate pretend dramas
• Using play scripts
• Video Clip Example

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Developmental Stage 6 Emotional thinking, logic
and a sense of reality

• Build bridges between ideas
• Become the object
• Use different characters with lots of affect
• Use 2 voices (ie. Hungry bear)
• Play dumb
• Focus on facilitating an exchange of words or
  short phrases, not grammar (pragmatic language)
• Video Clip Example

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Common Floortime Problems

• Doing too much and doing too little
• Prompting too much, not waiting for child to open
  circles
• Following the childs lead but not being engaging
• Teaching instead of having fun interacting
• Not rewarding/reinforcing interactions/language

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A Good Floortimer(Greenspan)

• Uses supportive body posture (face to face)
• Reads the childs cues (behavior, language,
  gestures, relating style, rhythms)
• Follows then helps expand childs lead in a
  non-coercive, playful and encouraging manner
• Can help child identify play themes but doesnt
  turn the session into a teaching/learning session

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A Good Floortimer(Greenspan) cont.

• Lets child know you are supportive and caring
• Knows when to talk, when to be quiet/observant
• Senses the emotional needs of the child
• Treats what the child is doing as purposeful

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Conclusion

• Floortime involves following the child's lead
  and pulling him into your world, then going
  beyond that by challenging him to master each of
  the developmental levels. It requires paying
  attention to the child's individual processing
  differences and nervous system, to family
  patterns, and to your own personality (to learn
  how you need to stretch to work with the child)
  ---- Stanley Greenspan Serena Wieder (Engaging
  Autism)

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References and Resources

• Engaging Autism Using the Floortime approach to
  Help Children Relate, Communicate, and Think/
  Stanley Greenspan Serena Wieder, 2006
• The P.L.A.Y. Project (Play and Language for
  Autistic Youngster)/Richard Solomon, M.D.