Tag Archives: autism in toddlers

Lining Up Toys Doesn’t Mean Your Toddler Has Autism

 

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After head-banging, Why Head Banging Doesn’t Make Your Toddler Autistic, this is the other behavior that seems to terrify parents of young children.  Seeing a row of vehicles on the carpet makes parents run to Google in fear.  Well, I want all of you to take a deep breath and then exhale.  The truth is that there are a few other behaviors that are more indicative of autism.  Here is what I think that row of tiny toys often means:

Very young children have a natural interest in order and understanding spatial relationships.  Kids like routine and familiarity way more than most adults.  Some children are just experimenting with how lines are formed or seeing how long a row of cars they can create.  Some will even match colors or sizes.  And it is OK if Lightening McQueen has to be the first in the line.  Sometimes routines have purpose.  When your child tells you that you read Goodnight Moon wrong (you just paraphrased to end it early and get him to bed), he is really saying that he likes the familiarity and the orderliness of hearing those words said in that order.  Boring to you, comforting to him.  Experts in early literacy will tell you that his fondness for hearing the same story over and over is actually a developmental milestone in phonemic awareness, the cornerstone of language mastery.

Controlling their environment and creating patterns is another reason to line up those cars.  Young children do not create complex play schemes about races or adventures.  Lining them up is developmentally correct play for very young children, and it can easily expand with a little demonstration and engagement with you.  Build a garage from Megablox and see if your child will enjoy driving each one into the garage to “sleep at night”.  (Don’t mention that in real life we all use our garages as storage units! ) Typically-developing children may even repeat your game later the same day, having learned a new way to play with their toys.

When does lining up toys become troublesome?  When it is the ONLY way that your child interacts with those toys, or with any toys. And when you try to expand their play as above, they lose their lunch because it is all about rigid routines, not object exploration.  If your child is on the spectrum, that line of cars is part of their environmental adaptation plan for security and stability; it’s not actually play at all.  There isn’t a sense of playfulness about changing things around or using these objects for imaginative play.

A lack of developmentally-appropriate play skills is certainly a concern to a child development specialist, but it still doesn’t translate into autism.  Here are a few of the behaviors in 1-2 year-olds that concern me much more:

  • little or no eye contact when requesting something from you.  They look at the object or the container, not at you.
  • no response when her name is called, or not looking toward a specific person when the name of a family member is mentioned.
  • using an adult’s hand as a “tool” to obtain objects rather than gesturing, pointing or making eye contact to engage an adult for assistance.
  • a non-verbal toddler (over 18 months old) that doesn’t use gestures such as pointing or babbling to communicate needs or desires.

Always discuss your concerns with your pediatrician, and in the U.S., consider a free evaluation through your local Early Intervention program if you continue to see behaviors that keep you up at night.  Therapy services are free as well, and they continue until your child is eligible for school-related services provided by your local district.  They can help you!

If you are looking for strategies to help your child handle daily life tasks such as cutting nails or tolerating hair cutting, take a look at Why Cutting Nails Is Such a Challenge for Autistic and Sensory Kids and What Helps Sensitive Kids Handle Haircuts?.  I have transformed my own reactions to toddler behavior with Dr. Harvey Karp’s Happiest Toddler on the Block methods.  To teach your child self-control skills without punishment or shaming your child, take a look at Stretch Your Toddler’s Patience, Starting Today! and Discipline and Toddlers: What Do You Say if You Don’t Want to Constantly Say “No”? .

Are you struggling with toilet training?  Does your child have low muscle tone?  Then I wrote a book just for you!  The Practical Guide to Toilet Training Your Child With Low Muscle Tone is my e-book that gives you real assistance, not just “don’t rush him” or “wait until you see signs of readiness”.  I teach you how to spot and create readiness, and build your child’s skills so that they can succeed! Read more about my book at The Practical Guide to Toilet Training Your Child With Low Muscle Tone: Potty Training Help Has Arrived! .  You can purchase my e-book on my website Tranquil Babies , on Amazon , or at Your Therapy Source , a terrific site for occupational therapy materials.

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Autism and the Happiest Toddler Approach: Why Does It Work?

All children on the autism spectrum have two things in common:  they have difficulty with communication and less social skills than would be expected for their age.  Many, but not all, children with ASD struggle with sensory processing.  The level of struggle is so unique that these kids look very different from one another most of the time.  But when they get frustrated, they all can break down into aggression, avoidance and tantrums that last and last.  I recently attended a professional training where the presenter remarked that those meltdowns were not only a sign of autism but inevitable, and “you just let the child have his tantrum”.   I think that abandons the child when he needs the most support, but is the least available for traditional talk-based or token strategies.  I have also spoken with behavioral-managment clinicians who go straight through to a time-out warning when a child begins to resist or complain.

So why does The Happiest Toddler (THT) strategy work well for children on the ASD spectrum?

At first glance, it seems that it would be less successful than standard behavioral approaches, as it relies on reflecting back feelings and supporting social and self-control skills.  Initiating and sustaining direct verbal give-and-take is often the greatest limitation of these children.  Kids on the spectrum really benefit from the emphasis on non-verbal messages, the repetition, and the indirect teaching that occurs using Dr. Karp’s techniques.  The adult matches the child’s language level at the time of the tantrum, and social interaction matches a child’s skill level as well.  If a child with ASD is able to function above an 18-month level, at any chronological age, then this approach can be very effective in helping him achieve a calmer state and learn self-control skills.

I modify the program to assume that a child will need more opportunities to practice and fewer distractions to use techniques such as Gossiping and Patience-stretching. My target level of repetition, voice volume and language complexity may have to be very fine-tuned for each child.  I may need to select words that he commonly uses, or words that have previously shown a positive response.  I will strive for consistency in my delivery once I have created a plan, and accept that generalization of using THT (expanding this to other situations, or even to the parents and nannies) is going to take longer.

This strategy works more effectively with a “floor-time” model than with an ABA model, but it can be used with any program.  The definitive measure of whether this approach will work is the willingness of adults to adapt their response to a child’s unique emotional and communication needs.

Take a look at the technique demonstrated on a “Good Morning America” segment to give you an idea of what it looks like in action. http://youtu.be/lrxBKvV1p-A