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Language Therapy as a Game
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===What about the Benefits of TV?=== Remarkably, our study didn’t find any. Aside from measuring combinatorial language and voluntary imagination through MSEC, our study tracked Autism Treatment Evaluation Checklist (ATEC) scores. ATEC measures your child’s progress in four areas: (1) Speech/Language/Communication, (2) Sociability, (3) Sensory/Cognitive Awareness, and (4) Physical/Health/Behavior. (The complete ATEC questionnaire is available free of charge [www.autism.org here]) All children in our study improved in all areas, but the high screen-time group did not statistically outperform the low screen-time group in any measure. When I talk to parents about screen time, they often point to new vocabulary as their best defense. It goes something like this: “My child is already behind his age group. Where in his daily life will he find everything that happens on his favorite shows?” Hold that thought! We know from Chapter 2 that voluntary imagination must take priority over learning new words. That said, taking a break from the movies doesn’t mean depriving your child of great story time. Read to him. Listen to an audiobook together. Throw in a few questions and answers, and his brain gets a full workout in addition to his daily dose of vocabulary. Finally, I suggest your child will get more out of an interactive and challenging learning game than from any passive screen time. A case in point is four-year old Rocco, who plays MITA with his father several times a day. <blockquote> “One game in MITA is about a full and an empty glass. I know for a fact nobody taught him these words before. I started him on that game at the basic level and took him all the way up to the highest difficulty. Today, I was serving the juice. I poured the last drop, and he said: ‘It’s empty.’ Another game is matching cars. It’s his favorite. Sometimes when we walk down the street, he points to a car and says: ‘Same car.’ He can tell that the car is similar to mine.” </blockquote> If you like the idea of learning apps, choose the ones that challenge your child’s thinking. The more effort it takes to complete each step, the less addictive the app. Once children run out of “cognitive energy” they lose interest in the game. This is one of the design principles we use to make MITA non-addictive. Another one is to keep sensory stimulation to a minimum, both to reduce distractions and to eliminate the risk of addictiveness. To get the most out of your app, make sure your child doesn’t guess the answers. Encourage him to solve the puzzles in his mind and only then to press the buttons. Trial-and-error defeats the purpose of the game, which is to get your child to work out the solution in his mind’s eye. Pay attention to the physical environment in which your child plays learning games. Choose a quiet spot with few visual distractions. This will help focus his attention on the game and speed up the learning process. Bonding Is Therapy Autistic children often have no trouble entertaining themselves. The challenge is to get them to notice, connect, and enjoy the company of others. This is another reason to tread lightly on solitary entertainment, like TV, and to shift towards activities with more potential for shared play. Ten-year old Josh has caught up to his peers in school and has a strong interest in astronomy. His father, Alex, believes Josh is on his way to becoming an independent adult. The biggest success factor, according to Alex, is the emotional bond he has formed with his son since Josh was three years old. “He loved Legos. He could spend eight hours a day building a fire truck or a rocket. It was easy to leave him alone. If you weren’t trying to spend time with him, he didn’t ask for it. Trying to connect was like digging a tunnel: you move slowly and feel your way through. But in the end, he was no different than other kids. He enjoyed feeling a live being by his side, someone who took an interest in him. Once he opened up, we played games together. One was Treasure Hunt. I would hide a Lego piece and leave notes telling him where to find it. The first note said where the next note was, and so on. Another game was to draw his favorite characters and cut them out of paper. He used to obsess over Jack and the Beanstalk. We made paper dolls and role played. He was Jack and I was the evil giant. It became a turning point in the relationship: when you’re role-playing, you’re not hiding away.” Bonding may be the key that unlocks your child’s desire to imitate and join other humans. According to the social motivation theory of autism, this desire is critical to the acquisition of language. Without it, brain development takes a different course and resulting in a lifelong combinatorial language deficit. Usually, the bonding happens naturally as the child clings to the parent. In your case the roles may be reversed, and it’s up to you to break the ice. A 2013 study found fewer connections between the voice-processing and reward circuitry of the brain of autistic children compared to their peers.<div style="color: green"><ref> Abrams D.A., Lynch C.J., Cheng K.M., Phillips J., Supekar K., Ryali S., Uddin L.Q., Menon V., 2013. Underconnectivity between voice-selective cortex and reward circuitry in children with autism. Proc. Natl. Acad. Sci. U. S. A. 110, 12060–12065. 10.1073/pnas.1302982110 </ref></div> The degree of underconnectivity in the study was proportionate to the severity of the symptoms. In other words, your child’s brain may not be able to emotionally connect to your voice or your presence. But if you changed that, his symptoms would also likely improve. Can you help your child bridge the disconnect and grow a secure bond? That’s exactly what Alex did with Josh, and I encourage you to do the same. How you go about it will be unique to you, your child, and your family. Notice how building a bond allowed Alex to steer Josh from watching his favorite cartoons to playing challenging interactive games with his dad. Here’s how it worked: <blockquote> “I wondered why he stared at a close-up of a character on the screen but avoided eye contact with real humans. Why would he rather turn us off and turn on the cartoons? At the time, he was also obsessing over the Titanic. He sat for hours drawing one picture of a sinking ship after another. We had to take away the crayons to make him go to bed. The therapist said it was no good, an artificial world, we should drag him away from the TV and distract him from drawing too much. I thought, what if, instead of breaking up his world, I joined him there? At first, I just stayed in the same room. He didn't want me to watch him, so I’d pick up a book and pretend I was reading. He saw that I wasn’t out to ruin his fun, and he relaxed. A few days later he let me sit on the couch with him. I sat three feet away, and at some point he moved a little closer, still with his back to me. The next day, a little closer. One day he leaned on me. That’s when I knew he liked being together. After that, we started playing. He’d let me help with the Legos or draw on the same piece of paper. From there, we moved on to all kinds of games. It took weeks, maybe months to overcome his fear of contact. First he tolerates you, then he likes you. He feels joy from not being lonely. Then he accepts you into his world. Then he wants to communicate. When he wants to say something, he will find a way.“ </blockquote> Be patient and follow your child’s lead. When you make an opening gesture, like quietly watching your child play, give him a chance to accept or reject it. Let him set the boundaries and be in control of when and how the bonding happens. Wait for his response and enjoy the subtle intimacy as you and your child get to know each other. Nothing brings us together as quickly as sharing a laugh. Anytime you can make your child giggle is a win. Alex’s favorite trick is to play forgetful. <blockquote> “He likes to take care of others for a change. I pretend that I forget how to put on a shirt, and he shows me how to do it. At night, I’d say: ‘Let’s go brush hands.’ He laughs and corrects me. It makes him feel good about himself and helps him mature socially.” </blockquote> While Alex built bonding rituals around his son’s hobbies and obsessions, Ricardo noticed that his son liked to help around the house and used the chores to interact with his child. <blockquote> “He asks to sweep the floor after dinner, to feed the dog, to put the dishes in the dishwasher. He folds the clothes and puts them in his drawer. When he wants something, I tell him where to get it. He can follow rudimentary instructions. It's working. Today I increased the level of the game on these subjects in MITA.” </blockquote> The bonding starts with your child feeling safe and relaxed in your presence. When he’s ready, join him in his favorite pastimes. It could be a creative activity like coloring, playing, or singing. It could be physical movement—running, jumping, dancing, or even house chores. It could be food. It could be anything he likes. Let him find out if he likes it better together.
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