By: Amy Smith, OTR/L

Cooperative Games- these are a few of my favorite things!  As an occupational therapist, I try to challenge the children I work with, supporting them along the way while working on their areas of need & sneaking in some fun!  Using cooperative games has brought with it smiles, full-on giggles and children that are working on oodles of skills!

What Is A Cooperative Game?
It’s a game where everyone plays together, no one is left out, and everyone has fun! Unlike a traditional game where there is one winner and one (or many) losers, in a cooperative game the players work as a team against a common obstacle, not against each other.  This model emphasizes play, not competition. Kids experience shared decision-making, build self-esteem & confidence, learn to share and to work as a team.  Cooperative games also encourage inclusion, eliminate stress and teach kids that playing together can be fun!

Why Children Benefit:
They are perfect for children who need a boost in confidence because the pressure of winning is off.  Peaceable Kingdom has a variety of preschool skill builder games that target children age 3-6. These games have 3 levels of directions. As a therapist, we often grade a game and/or activity up or down to help meet the needs of each child-essentially making it easier or harder (this is already built into the game).  In a 1:1 therapy setting, a child can begin a game at the 3-4 year old level and as they gain understanding of the game and build skills they can progress to the age 4-5 and/or age 5-6 set of directions-they can grow with the game and the game can grow with them.   Adults playing can play at the most advanced level of directions and/or work at their child’s level.

In group settings these games can be used at the level of each child present without separating games for each individual. Children improve comradery as they together strategize and attempt to beat the game. Children’s faces light up when they know we are both on the SAME TEAM and WE are going to try and beat the game. It’s not about me giving them a challenging task and sitting back- it’s about joining them.

For families, many children are 1-3 years or so apart from their siblings. With 3 levels of directions designed into each game, one game can suit the needs and developmental skills for siblings that are even 3+ years apart-encouraging a family to sit down for a game that is both fun and therapeutic!  Games are designed to be played in 15 minutes- an appropriate duration for this age group.

Feed The Woozle: My Favorite!

Children roll a dice to see how many snacks they get to select for the Woozle. Options include: chocolate-covered flies, hairy pickles & other silly/yucky snacks. You can set up the Woozle close by or place it in the next room (added challenge).  Children load the snacks on a spoon and then spin the spinner to determine what move they need to do while bringing the spoon of snacks to the Woozle’s mouth (march, go crazy, hula dance, spin, walk backwards). Get the snacks to the Woozle’s mouth without dropping them & you get a yummy card! Once the group has collected all 12 yummy cards, you win! The silly snacks cause some serious giggles & children love to see their therapist, teacher, parent, sibling and/or friend trying to hula dance or spin without dropping the snacks before the Woozle can gobble them up! This game is great for children who don’t like to sit still and like to be on the move! It has the silly factor, yet is challenging. I’ve seen that children are very attentive since they get to use their whole bodies (helps children obtain & maintain appropriate level of alertness/arousal needed for new learning).

Some skills addressed through use of these games:

• Turn taking & social skills
• Body awareness
• Motor planning & coordination
• Modulation of motor movement & impulse control
• Sequencing of multiple step directions
• Counting
• Development of fine/visual motor skills & dexterity

Although the game designers did not develop these games for children with special needs, I’ve found them to be a new invaluable resource for therapists, families and teachers.

Amy Smith, OTR/L has over 12 years experience as a Pediatric Occupational Therapist.  She shares Kids Development Studio with Elaine Westlake, MA, PT in San Francisco, California.  Check out Amy’s Website for help Maximizing Your Child’s Potential!

By:  Jennifer McIlwee Myers, Aspie At Large

I have a younger brother with autism, seeing how similar his traits were to mine led me to seek and obtain a diagnosis of Asperger’s Syndrome when I was 36.

Fortunately for me, a big chunk of those undiagnosed years were spent being raised by remarkable parents.  My mom knew that something different was going on with me.  She watched me carefully, watched family members with similar problems, and came to the conclusion that she needed to push me harder to do things for myself.

More than good grades, more than being clever, more than traditional academic achievements, my mom wanted me to learn life skills.  Her philosophy was that the main responsibility of the mama bird is to kick the baby birds out of the nest.  Everything she did was with that goal in mind.

As she watched me, she figured out where, when, and how to push me.  As a preschooler I was highly verbal but tended to hide behind adults and let them do the talking.  She pulled me out from my hiding and made me do simple things for myself.  At three, I had to ask for the restroom key at the gas station by myself with a parent nearby.  I had to learn to order for myself in restaurants.  As soon as I could physically do so, I had to write my own letter of complaint to the Topps Company because of a problem with my Charlie’s Angels bubblegum cards.

One time when my dad and I were at a record store (between that and the Charlie’s Angels reference I’ve dated myself thoroughly) the music was too loud for my sensitive Aspie ears. I asked my dad to fix the problem.  Instead, he had me ask for the music to be turned down on my own.  This worked, without any need for an IEP item on learning self-advocacy.

Yes, I know that IEPs, OTs, and other wonderful acronyms are helpful and vital to most kids diagnosed with autism spectrum disorders.  However, nothing can replace real world experiences and the benefits of pushy parenting.

I learned life skills because my mom knew I wasn’t going to learn them on my own.  She had the instinct, or wisdom, or whatever you might call it, to see this big missing piece in my Aspie brain. This caused her to work overtime to make up for it.  This was very important, realizing that her first kid would have a harder time learning to take care of herself made her push me to practice and experience speaking up for myself.

The thing is, auties and Aspies at all “levels of functioning” can and should be taught to do as much for themselves as possible.  The child who can walk up to the counter at McDonalds and use PECS to place an order is light-years ahead of the child who can talk but has no idea how to buy whatever he needs.

My brother learned to order his own Happy Meals when he was about 5.  Did I mention that my brother has autism?  When I asked my dad about how that learning process went, he said, “Well, the first 15 or so times were pretty rough.”  At one point the manager walked out from behind the counter, went up to my dad and said, “Sir, can’t you control your son?”  My dad replied, in simple honesty, “Apparently not.”

I use McDonalds as an example, but the specifics aren’t important.  What is vital is that my brother and I learned how to do simple transactions early and had to practice often.  Getting that bathroom key, getting the music turned down, ordering lunch, buying yet another Thomas the Tank Engine train: these are all just basic transactions.  However, doing them independently meant we were treated like real people, not just disabilities with feet.

In fact, doing things for yourself is one of the most effective ways I know to change how others see you.  It causes the people around you to move out of “looking at the strange person” mode into interacting and maybe discovering that there isn’t a problem with “strange” people.

This is the most vital part of teaching life skills: it makes others see those of us on the spectrum as real, honest-to-goodness people.  The more we can do for ourselves, the more we get to see ourselves and be seen as part of this gigantic, joyous, sorrowful, amazing mess known as the human race.

I could go on, but that’s it, really.  Interacting, cooperating, turn-taking, and all of that incredibly basic stuff helps us to connect to our own species in a meaningful way.  Isn’t that what being human is all about?

Jennifer McIlwee Myers is known as the “Aspie at Large.”  She is a national speaker and the author of How to Teach Life Skills to Kids with Autism or Asperger’s.

Sensory Integration is a theory originally developed by Dr. Jean Ayers an occupational therapist with training in neuroscience and educational psychology.  Dr. Ayers described sensory integration as a “neurological process that organizes sensations from one’s own body and from the environment thus making it possible to use the body effectively within the environment”.  This theory attempts to explain the relationship between sensory experiences and behavior.

Many children with autism have unusual responses to sensory stimulation that can cause them to react to their environment in unusual ways.  This can affect learning, self-help skills, social skills and more.  Some common signs of problems with sensory integration include:

• Over reacting or under reacting to common sensory experiences.
• Fear of noises, frequently covering ears or an acute awareness of background noises.
• The child may respond to normal touch sensations as if they were painful.
• May crave or refuse to touch certain textures like paint, play dough or sand.
• They seem to have little awareness of pain or temperature.
• Unusual activity level, the child is either very hyperactive or under active.
• A child may have an extreme dislike of certain grooming activities, such as washing their hair, brushing their teeth, washing their face or having their hair brushed.
• A child may seek out or crave sensory sensations like touch, rocking or spinning movement, or have a fascination with lights, fans, water or spinning objects.
• The child may avoid certain tastes/smells that are typically part of children’s diets or constantly seek to smell non-food objects.
• Coordination problems: they may have trouble on play equipment, seems to tire easily, hesitate going up and down steps, frequently bump or crash into things.

If you suspect your child may have sensory integration problems make an appointment to have them evaluated by an Occupational Therapist trained in sensory integration.

By: JD Kraus

1. Be Yourself.
As hokey as this sounds it’s the truth. There is no point in pretending to be someone that you are not. As a teen, I tried to make friends by acting that I liked sports (since so many kids at my school were sports buffs), but I never really cared for them. It not only made me feel bad, but it got me nowhere in developing friendships. Being yourself is being true to your own identity.

2. Be open and willing to talk to others.
In the real world, you cannot be a clam. If you have a question in a class, raise your hand and ask the teacher. If you want friends, you’ll have to go out of comfort zone and talk to people. The best way to befriend someone is by asking them a question, like “What’s your favorite movie?” A little inquiry like this can start a conversation, and a conversation can lead into a friendship. This is especially important if something or someone is bothering you. It is

3. Reward/set time aside for yourself.
I know days of school and work can be tough. To help get through the day, set some personal time aside for yourself each day. This can be playing a favorite video game, watching a TV show, etc. Squeeze at least an hour a day of this personal time. The purpose of this is to give you a chance to relax and “recharge your batteries.”

4. Do something you enjoy in school.
I know this sounds hard, but it made the difference for me. When I attended the vocational school in my junior year of high school, it had a positive impact on me, for I was in a digital design program—something I enjoyed learning. Look for courses that pique your interest.

5. Have fun.
This really relates to all of the topics I have mentioned above. As absurd as it sounds, having fun in life (both at school and at home) makes the difference in developing an easygoing, worldly experience. How you go about doing this is entirely up to you. For me, it is spending time with my family, playing a favorite video game, and working in small groups for school related projects. I guarantee that once you find something that you relish, it will make many of your problems go away.

J. D. Kraus is the author of The Aspie Teen’s Survival Guide and was diagnosed with Asperger’s Syndrome in the fourth grade. He is currently finishing his degree at the University of Cincinnati, and continues to overcome challenges while embracing his differences.

By: Mike Tumlin
Twelve years ago if anyone would have told me all the things I’m doing today, frankly I would’ve told them that they were crazy. I was at the end of my rope. My children had been displaying many undesirable and socially unacceptable behaviors and I was completely ignorant about autism. I was in complete denial and being raised on the end of a hickory stick I thought that what my kids needed was discipline.

About this time I left the construction industry and was hired by Norfolk Southern Railroad as a conductor. At the time I thought this was the best job a blue collar, uneducated person like myself could get. The problem was that when you work on the railroad as a conductor you work the “Extra Board”. This meant I had random shifts, worked 70 to 80 hours a week and was guaranteed only 8 hours of rest after each twelve hour or less shift.

During this time I blamed the behavior of my children on my poor wife! I thought she was not disciplining the kids enough. Meanwhile most of the time I was only home for 8 hours and then off to Atlanta for three days at a time. I know now had I stayed at the Railroad I would have surely lost my wife and my children.

With things so far out of control in my life, I turned to God and started to follow the teaching of the Lord Jesus Christ. I began to pray and God began to answer my prayers and I came out of denial. I began scanning the internet reading and desperately searching for what was wrong with my children. Christ led me to an article about Einstein that mentioned that he may have had Asperger’s. I then did a search and found a rating scale and it was like it was describing my son to a tee.

When we finally got the diagnosis I felt that things would finally get better and I would be able to turn the diagnosis over to the school and all would be well. Well it didn’t quite work out like that. The teachers and the school here in Alabama didn’t know anymore about autism than I did.

Since I was a new employee at the Railroad and destined to be on the Extra Board for a minimum of 15 more years my wife and I quickly realized that one of us would have to come home and quit letting the day care raise our children. Her job was better for our family so I quit. This cut our income in half and was a big blow to me being a male but it was the best decision for our family.

Though we may not have a lot of money we feel very blessed by God’s goodness. The cars that were new when our kids were first diagnosed are still on the road, both with over 300,000 miles each. This may not sound like a blessing to many but this has been a blessing to us. With each breakdown and repair Christ has guided my hands as I make each repair and our cars are still moving.

During this time I felt that God wanted me to start a support group. To be perfectly honest I fought this notion and asked God to give this job to someone else. Maybe someone with only one child with autism. But God’s answer kept coming back the same, “I’m going to take care of your children and you are going to help me take care of many more.”

In my dreams I would always see a sign with red letters and a T on top of it. This just didn’t make sense to me as I live in the sticks and we didn’t have so much as a red light much less a flashing sign. Around this time I was taking my kids to school each day and watching as they built a new church on the way. Then one day I saw it! It was never a “T” that God was showing me in my dream but instead it was a big red cross right on top of the new sign they were building in front of the church.

I went home and asked God to guide me to whatever he wanted me to do. I never built a website but with God’s help I built what eventually became the Alabama Autism Support Network. Next, I began working on a way to find people to join what I thought was going to be a small support group at the new church. I went in and talked to the pastor and to my surprise he was completely supportive of my idea. By this time it had been four years since my children’s diagnosis and we had never met another parent with a child on the spectrum, the website was our only way to connect with others.

Well it turns out that this was just the beginning of what God had in store for me. I developed an “OCD” if you will of learning about autism and sharing that knowledge with others. I began sharing what I learned on the Alabama Autism Network and folks from all parts of the state began to find us. Just like autism does not know county lines I could not turn folks away saying that this was just my school, or county, or state so now our network is open to the world. It turns out that there are so many folks like my wife and I that want to talk with other parents and learn about autism. We are now the largest support network in the Southeast growing at about two people a day. I thank God for the network because he knew we all needed it. I now also travel across Alabama to help get more face to face support groups started in our state.

My Lord Jesus Christ continues to meet all of my family’s needs. Many times at the last minute the phone will ring and the solution to whatever the problem may be is given, whether it be financial, words to say, or how to raise my children. I stand on God’s promise to us all that he will never put more on us than we can take. I have faith that he will continue to take care of my family and continue to take care of my children by helping them rehabilitate.

Though many of these victories would seem trivial to many folks they mean the world to my family. So now when I’m asked, and I’m asked often, what has been the best therapy for my children that are doing so well. I immediately without hesitation can say “Jesus Christ”! I pray that if you are reading this that you will give God a chance! It will be the best thing that you have ever done- I promise. For your guarantee that eternity will be so much better than this world please read John 14.

Mike Tumlin is the founder of Alabama Autism & Asperger’s Support and Info Network www.AlabamaAutism.org.

By: Elizabeth Bonker and  Virginia Breen

If I had to identify one crucial skill for any mother trying to find her way through the maze of autism, it is this: learn to understand the difference between a diagnosis and a label.  At each stage of her life, my daughter has defied the labels assigned to her.  Elizabeth has autism and is functionally non-verbal.  Although she was diagnosed as mentally retarded at age two and a half, we knew that was only a label, and an inaccurate one at that.  Her true diagnosis is brilliance and her intelligence has now been tested in the genius range.  But it took us years to prove what we always knew:  she was in there desperately trying to break free from her silent cage.

When Elizabeth was six years old and starting to hit herself in frustration from her inability to speak, we were blessed to find Soma Mukhopadhyay.  Soma taught her own son, Tito, to “write” by pointing out letters arranged alphabetically on a piece of laminated paper using her Rapid Prompting Method (RPM).  We had to give it a try.

On one of our first visits to Austin, Soma asked Elizabeth to write a word that started with A, and to our surprise Elizabeth typed, “Agony.”

Soma asked her if she knew what agony meant, and she replied, “Quite so.”

I was in the room and started to shake.

Soma took a deep breath and asked again what agony meant, and Elizabeth typed, “Pain.”

“What causes you agony?” Soma asked.

Elizabeth gave her a sideways glance, filled with exasperation, and typed, “I can’t talk. I am stressed. I have no way to say that I am greatly bored with my day.”

When Soma tried to commiserate with her by saying she is also often bored, Elizabeth banged her head with her hand and typed, “But you talk.”

Soma has freed more than a thousand adults and children from their silent cages.  If your child is non-verbal, please look into RPM at www.halo-soma.org.

Besides typing out her schoolwork, Elizabeth mostly communicates by writing poetry because she can pack a lot of meaning into few words.  Her poetry tells us about the inner world of autism and shines a light on the world around us.  She wants the world to know that just because she is non-verbal doesn’t mean that she her brain isn’t functioning.

Elizabeth wrote this poem and reflection when she was nine years old after one speech expert suggested that maybe she just didn’t want to talk.

Me
I sometimes fear
That people cannot understand
That I hear.
And I know
That they don’t believe I go
To every extreme
To try to express
My need to talk.
If only they could walk
In my shoes
They would share my news:
I am in here
And trying to speak everyday
In some kind of way.

I wrote “Me” to let people know that even though I don’t speak, I feel and understand the world around me.  I want to be heard and respected.  I want that for everyone, especially for people like me.

Over the past dozen years, we have seen many experts at world-renowned institutions in our quest to help Elizabeth.  All too often the initial visit starts off with a conversation like this:

Doctor:  Tell me about Elizabeth.

Mom:  Elizabeth is fourteen, she has autism and is non-verbal but she is…

Doctor:  OK, so she is low-functioning…

Mom:  If I said she was blind, would you have said she was low-functioning?  I was about to say she is very bright and communicates by typing on an iPad.

Doctor:  Oh, I see.

It is our hope that the doctors learn to see autism with new eyes.  That they don’t jump to label our kids’ complex medical issues as “autism” but treat their brains, guts and immune systems.  That they don’t equate a lack of verbal expression with a lack of language, a lack of interiority and, worst of all, a lack of personhood.  That they assume intelligence.

Elizabeth is full of hope for the future.  Will you join her plan to change the world?

Bright Future
When you see
A tree
Think of me
Growing strong and tall.

When you see
The sun shining brightly
Think of me
Tough and mighty.

When you see
The water on the lake
Think of the future
I plan to make.

Me
Strong
Mighty
Free

Elizabeth Bonker and her mother Virginia Breen just published I Am in Here: The Journey of A Child with Autism Who Cannot Speak but Finds her Voice (Baker Publishing).  For more information and resources to help your child, visit www.IAmInHereBook.com.

By: Beth Aune, OTR/L, Beth Burt & Peter Gennaro

Today, more than ever, educators are faced with teaching core subjects for longer periods to prepare the class to master state standards.  This requires the students to sit at their desks for long periods, and they may lose focus.  Many students may have challenges with sustained sitting and have a sensory need for movement to help them maintain an alert state.  The student may leave his seat to pace, invent reasons to get up (sharpen pencils, get a drink of water, get some tissue), or stand up at his desk.

Here are a few behavior solutions:

• Schedule movement breaks for the entire class inside the classroom, such as standing to “stretch and wiggle.”
• Allow the student to help pass out papers, clean the board, or assist the teacher with technical media.
• Let the student stand at the back or perimeter of the classroom or at his desk.
• Allow a very motor-restless student to have a movement break outside the classroom.
• Use oral strategies.  When the mouth is kept bus, often the body will feel calmer and the student can sit still.
• Provide hand fidget tools, such as squeeze balls, tangles, rubber bands, and paper clips.

Was this behavior solution helpful for you?  If so check out Behavior Solutions in the Inclusive Classroom and the companion book More Behavior Solutions In and Beyond the Inclusive Classroom.

Excerpt from More Behavior Solutions In and Beyond the Inclusive Classroom, copyright 2011 Beth Aune, OTR/L, Beth Burt & Peter Gennaro. Used with permission. All rights reserved.

This week we will look at simple strategies to help children with autism get some sleep.  Dealing with sleep problems and autism requires a multifaceted approach.  If you have not had a chance to read them, check out our articles Creating a Good Sleep Environment  and Autism and Melatonin.  If you are having sleep issues with your autistic child talk to your pediatrician, therapist or medical professional for guidance.  You can even print our sleep articles for your discussion.

Preparing for Bedtime by Limiting Daytime Sleep
The most effective intervention for insomnia is restricting daytime sleep.  This can be very difficult if the person with autism is in the habit of taking naps and a parent is exhausted.  If you don’t think you can stop your child from napping immediately you can begin to eliminate naps by systematically waking your child up early.  Each day your child naps, instead of letting them wake up on their own,  wake them up 10 minutes early.  Continue to decrease their nap time until they are no longer taking naps.

Most experts agree that around the age of 15-18 months, children only need one nap a day.  For younger children who still need a nap time, make sure they don’t nap past 2 pm.  The average amount a young child naps is  60 – 90 minutes.  If your child is sleeping longer, continue to wake them up early until the nap time no longer interferes with night time sleep.

Find the Right Bed Time
Prior to setting your child’s bedtime, take the time to observe your child in the evening.   Track when they start to slow down or look tired.   This is the time they should be in their bed going to sleep.  Next,  plan the autistic child’s bedtime routine so that it is finished and they are in bed at this time. If your child has difficulty sleeping you don’t want to go past this time because they could get a “second wind” making it very difficult to get them to sleep.

Create a Nighttime Routine
Creating a bedtime routine will help your child transition from the day to sleeping time.  Some common bedtime activities include:

• Brushing teeth
• Getting a small drink of water.
• Taking a warm bath or shower.
• Going to the bathroom.
• Having a slow rhythmic massage.
• Reading a bedtime story.
• A hug or kiss.
• Listening to quiet or calming music
• Watching a slow rhythmic object like a liquid timer, some kind of motion lamp or the tranquil turtle.
• Say my prayers.

As you create your sleep routine,  pay attention to how your child responds to different activities.  Each child is different so some of these ideas may alert your child or wake them up. Most people with autism do very well with consistency and routine.  Once you create a bedtime stick with it as best you can and try to maintain the order of the routine.

Use Visual Supports
Some autistic children find comfort and benefit from a visual bedtime schedule.  A visual schedule can be a sleep chart, list of words, a list of simple cartoon drawings or actual photographs of your autistic child as he or she goes through their nighttime routine.

Next we will talk about relaxation exercises to help your autistic child go to sleep.

By: Rebecca Michi

Bedtimes are often a challenge for families who have children on the autism spectrum. This can be extremely exhausting for parents.  After a long hard day parents want their children to go to sleep fairly quickly and easily. Fortunately, there are a few things you can do to make bedtime just a little easier.

Make your bedtime routine as consistent as possible.

All children thrive on routine, having a consistent bedtime routine will help your child fall asleep a little easier.  You want your bedtime routine to be between 30 and 45 minutes. Do exactly the same thing, in exactly the same place, in the same order every night. The routine will become very predictable to your child and they will be able to unwind a little and relax before you even attempt to get them in to bed.

Keep things calm.

This isn’t always easy in a house with children, especially towards the end of the day. But try and keep the house calm in the run up to bedtime. An hour before you want your child to be getting into bed, begin to slow the house down. Dim the lights, out on some calming music. If you can slow down and calm a little your children will be more likely to do the same.

No screen time.

It really is important to make sure all screens are turned off at least one hour before bed (preferably two hours). No TV, no computer, no phone, no iPad, nothing. When in front of a screen we are unable to produce melatonin as screens emit blue light (the same as daylight). Melatonin is a sleepy hormone it induces sleep. We produce it when we get into a dark and dim environment. Let’s make the most of these natural sleep-inducing hormones and encourage their production, not inhibit it.

Good Night, Sleep Tight Reward Chart

Go slow.

When making any changes to your child’s sleep or sleep habits things won’t happen quickly. It may take weeks for you to see some change. That doesn’t mean that these things are not working. There is no quick fix.  Just take your time and be prepared for it to take a little while.

Reward good behavior.

Introduce a rewards chart. The ‘Good Night, Sleep Tight’ Reward Chart I developed with The Victoria Chart Company is a great help. It let’s your child see the routine before bed and get rewarded for it as well as give them an incentive to stay in bed during the night.

Rebecca Michi is a Children’s Sleep Consultant, radio show host, writer and speaker. Her passion is creating happy, healthy and harmonious homes by helping your children get to sleep. With sensible and supportive techniques that are tailored to your child, your style and your life, she can help you turn drama into dreamland!