See VIDEO BLOG created on December 13, 2016

Last week we went through an example of a Floortime session and many more will follow. This week we’ll focus on some stumbling blocks that parents come across when trying to play with their children, and how you can move past them. We will focus on the first functional emotional developmental capacity (FEDC 1) today since it presents the most challenges for children on the spectrum as a whole.

DISCLAIMER: These are general suggestions and guidelines. Context is important and can impact how to handle a stumbling block. Children can also exhibit certain behaviours at home or with you that differ from those at school or in other settings with others. Please contact a professional for specific recommendations for your own child.

 

Tantrums / meltdowns

Please see the co-regulation blog from a couple weeks ago about how to handle tantrums and meltdowns by co-regulating. Only when the child is regulated and alert to share attention will we be able to work on moving him/her up the developmental ladder.

TIPS:

  • Give yourself permission to be frustrated but do not allow yourself to act frustrated; be soothing and easy on your child realizing (s)he is under stress and you are there to help your child through it, not add to it. Now is not the time to worry about discipline or to instruct your child to obey commands.

  • If your child is comforted by sensory input such as a back rub, use what helps comfort your child.
  • Going more slowly, especially if trying to transition your child from one activity to another, helps the child anticipate what is coming next. Some people find that using visual pictures helps the child see what will come next.

  • When possible, try to avoid situations and circumstances that you know will be hard for your child and induce a meltdown if you will not have the opportunity to co-regulate with your child to help him/her through it.

  • If you do have the time, it’s good to take the opportunity to work through the emotion/challenging situation with the child so (s)he knows it is o.k. to be upset, that (s)he can overcome it, and that life goes on. If we don’t present those challenges then the child is never really mastering FEDC 1.

  • Try to understand if the child is having a meltdown as a result of sensory issues (e.g., the environment is too overwhelming for him/her such as being too loud) or if it is a result of fear, which stimulates the flight, or survival, response in the brain. (Please see the box link to Jennifer Kolari’s C.A.L.M. technique from the co-regulation blog in which she describes how her technique switches the child out of a flight response.)

A technique discussed by Dr. Stanley Greenspan is that of learning a child’s boundaries. If a child tantrums when you approach them, you say “oh, ok!” and back up until they calm down a bit and then you approach again giving them a choice of two options related to what they are doing, such as “can I see your train or no?” 

Eventually if you are gradual and let the child be in control of whether or not you approach, you learn where the child’s comfort zone is to engage with you. By retreating and approaching again over and over, gently, you can also prolong the interaction between you and your child.

 

Child ignores all attempts at interacting / Child in his/her own world

Please see the nuts & bolts of Floortime blog from a few weeks ago for how to use playful obstruction to entice the child into an interaction by being a barrier to what they are doing while following their lead, and using high affect to get their attention.

TIPS:

  • You can create anticipation by slowly approaching them and telling them so (e.g., “Here…I…come!” in a playful voice).

  • Always make sure the child is in charge of his/her body and you are not forcing him/her to do anything. You want this to be playful and let the child be the one who gets to feel like (s)he runs the show and you follow his/her lead so (s)he will be motivated to keep playing with you.

  • You know you are doing well when the child is having fun and comes back to you for more.

 

Child repeats the same action(s) over and over

Some children engage in repetitive behaviours as a sensory need when they get overloaded.  Repetitive behaviour can also be due to a child’s challenges with motor planning, or being able to sequence actions.

If you recall from an earlier blog post, Dr. Greenspan’s affect diathesis hypothesis postulated that our children have trouble connecting affect to motor planning abilities. Our children might have many ideas of how to play, but don’t know how to execute those plans, so it’s easier to just repeat what they know.

TIPS:

  • If your child’s repetitive behaviour is due to a sensory need (“stimming”), try to anticipate when (s)he will reach his/her limit and provide the sensory calming (s)he prefers. A sensory diet can help prevent overload by providing sensory input throughout the day tailored to your child’s individual needs.

  • If your child’s repetitive behaviour is due to challenges with what else to do, treat what the child is doing as purposeful and join the child in what (s)he is doing. Use high affect such as an overly interested tone and facial expressions and essentially making it into a game. You might even get the child to stop and look at you doing what (s)he is doing and then you can take turns.

  • Once you have the child’s engagement, you can try to steer him/her to a more constructive activity or a more constructive way of meeting that sensory need, such as providing chewelry or chew noodles to bite on rather than biting on his/her shirt, for instance.

 

Child is violent to him/herself or others or child is doing something dangerous

According to Dr. Gordon Neufeld, aggression is the eruption of emotion from being frustrated with something you can’t change. Until you can accept this fact, you are unable to adapt and move on, so you get stuck in a frustration loop. Since this is an emotion problem and not a behaviour problem, disciplining the child or instructing the child to control his/her behaviour will not be an effective strategy. It will only add to the child’s frustration.

Again, please refer to the co-regulation blog about how to come along side the child’s frustration and add in a tempering element by empathizing with the child. “I can see that something isn’t working for you and you have frustration to get out. Let me help you find a way.”

TIPS:

  • The more you can help a child label his/her emotions and reciprocate gestures with you, the sooner (s)he will be able to handle his/her frustration. At this 1st FEDC, the child is still in fight or flight mode with his/her emotions, so you cannot expect emotional control.

  • Provide a pillow, a doll, or some object the child can be aggressive with at this stage. You can also provide an alternative behaviour such as tapping on the shoulder or giving a “high five” instead of hitting another child, for instance.
  • You will want to determine if the child is being aggressive due to sensory overload or out of defense, and intervene appropriately. Giving the child choice and control will help alleviate defensive aggression.

 

Child becomes overly anxious and/or overcome by sensory input (e.g., covers ears and screams)

Anxiety goes hand in hand with autism so much of the time. Anxiety is stress and comes from feeling like you have a lack of control. We do so much for our children, and often against their will (brushing teeth comes to mind), that they will often feel a lack of control.

TIPS:

  • You can help your child feel in control by giving him/her more control so (s)he can feel more confidence. For instance, if the child is scared by a loud noise, you can let him/her hold a dial that (s)he can turn up or down to adjust the volume of the noise him/herself. Dr. Stanley Greenspan has said that giving children control helps them expand their thinking abilities.

  • If you’re like me, you’re already thinking ahead and asking about children who are so controlling that they need everything to be exactly as they expect or they get very upset and anxious; children can show rigidity at each of the FEDC levels and all you can do is keep working on challenging them to move up the developmental ladder by working on having more and more circles of meaningful interactions in Floortime sessions.

Hopefully now you have some more tools to help you interact with your child when coming up against some stumbling blocks at the very first functional emotional developmental capacity (FEDC 1) of shared attention and regulation. We will look at the higher FEDCs starting in two weeks, but next week a guest blogger will tell us about motor planning and sequencing which is so often a challenge for so many of our children.

Until next week… here’s to affecting autism!

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