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978-1572305441

autism

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Free ebooks ==> www.Ebook777.com www.Ebook777.com Trevor 145 Trevor also showed more interest in the other children in day care. He would sit with them on the rotating tire in the playground. The more Trevor and the other children went to the playground together, the more his teacher had an opportunity to intrude on his happiness and get him to communicate his pleasure and enjoyment. She modeled, “Is this fun? Are you having a good time?” At first Trevor would echo these questions, but eventually he would spontaneously communicate to his teacher what fun he was having on the swings: He would smile, squeal with delight, say the word “fun,” and laugh with the other children. At first this was pure verbal imitation, but soon it became part of the routine on the swings, and eventually the words and the nonverbal communications became spontaneous. By teaching some basic skills in verbal imitation, in simple skills needed to construct a theory of mind such as joint attention (where both adult and child pay attention to the same object of interest) and eye contact, the teacher could start to shape more developmentally appropriate behavior. More and more, Trevor was able to fit in to the routine of the day care and behave just like the other children. Once Trevor learned more communication skills, both verbally and by using his pointing skills, his frustration level decreased and he became less aggressive. He did not have to resort to whacking his classmates to get them out of the way. With an outstretched arm, he could tell them to leave the room when he wanted to play with one of their toys. In addition, as his play skills improved, the periods when he would rock in the corner, flick his fingers in front of his eyes, and look autistic became farther apart. We never had to design interventions to reduce these “autistic” behaviors; they disappeared on their own as his social and communication skills improved overall. As these positive social relationships developed at day care, the potential to use the other children in the class as “peer tutors” became possible. Trevor’s teacher had to coach the other children on how to interact with Trevor, how to let him take the lead, how to avoid fights, how not to expect Trevor to share or take turns in play. But if they stuck to simple games like chasing, tag, and tickling, the other children in the class could have fun with him and they could play together. Soon Trevor sought out his classmates and wanted to play tag with them. Even more exciting was the fact that the other children were inviting Trevor to play with them. Trevor seemed to be actually enjoying the social interaction, even if it could be only at a relatively simple level. Imaginative play with his peers was beyond him at this point. That

146 A MIND APART would have to await the development of further language and symbolic play skills. Alice also reported that her own parents had to learn to let Trevor take the lead, to expect little in the way of proper manners in their home, and to appreciate what little social approach he made. Her father would take Trevor to the train station, and they would look at the trains together. Trevor had always been interested in trains since he had seen Thomas the Tank Engine on TV. This gave him pleasure, and his grandfather was happy to sit on the bench at the train station and be part of this little ritual that they shared. Afterward they would go to the local coffee shop and share a hot chocolate and a doughnut. * * * Over the course of the two years of this type of intensive therapy, Trevor’s improvements became more rapid, and the little victories seemed to cascade from one day to the next. Working intensively on a few pivotal skills in the social and communication domains made possible all kinds of other changes. It was like unlocking a key, only this time the key was social engagement, simple communications, imitation, and attentional flexibility and joint attention. Soon Trevor began to show an interest in the other children on the street. At first he didn’t approach them, but he would respond positively if friends called on him to come out and play. Eventually he asked to see them, but only on weekends (school time was reserved for school friends). This did not happen very often, but when it did, his mother would quickly take advantage of it. Alice arranged for a little girl to come to the house on weekends and play with Trevor and watch TV. After two years of this therapy Trevor came back for another visit. It was before his entry into kindergarten, and I had to fill in all sorts of forms for an educational assistant. I wanted to get as accurate a picture as possible of how he had done. “I am five years old!” he announced upon entering the office. “Are you?” I replied. “That’s old. But not as old as me. Did you have a birthday party?” “Yes, I did!” “Who came?” “My friends . . . from school.” Now that was a reply that was worth preserving for posterity. “Did you get any presents?”

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