Above our son is being redirected to put sand in the box instead of throwing it in the air.

See VIDEO BLOG created on April 11, 2017

A few weeks back, we discussed the developmental approach to setting limits. This week we delve into developmentally appropriate expectations of behaviour and also developmentally appropriate limit setting. We are very fortunate to have consulted with Dr. Gil Tippy who is a clinical psychologist and clinical director of the Rebecca School in Manhattan.

Development happens. It unfolds spontaneously like nature does when we provide the appropriate environment. That is, just as we cannot command a plant to grow, nor can we direct our children to develop. By providing a safe, nurturing, warm relationship within which the child can rest, play, and interact with us in moments of shared pleasure, development will occur before our eyes.

Children generally are happier, less stressed, and make more progress when involved in developmentally appropriate interactions and activities. In fact, these can constitute the most important factors in their growth.” (Page 257, Engaging Autism)

Dr. Stanley Greenspan

What Parents Want for their Children

When parents of children with developmental delays see other children achieving milestones that theirs haven’t yet, it feels unfair. Often, we parents want to teach our children skills so they can reach various milestones. This might include greeting people, reciting the alphabet, counting and eventually reading, writing and doing math.

Dr. Gil Tippy points out that we all want the same things for our children. Our dreams and goals are the same. From his perspective the best way to get them there is with DIR/Floortime®.

A few weeks back we discussed how focusing on academic skills does not help our children with challenges of thinking, relating, and communicating because they will be relying on their strong memories to get them through these tasks. We shared Dr. Stanley Greenspan discussing how there are necessary developmental steps to be attained before our children can thrive in academics.

Recall that our children’s brains never developed these foundational skills in early development like other neurotypical children, so we have to help the brain rewire these necessary connections. We do this by facilitating a back-and-forth continuous flow of emotional signalling, which is pre-verbal…even if your child is verbal.

The Tipping Point: A Precursor to What We All Want 

Dr. Greenspan felt that a major tipping point in development occurs when the child can get into a continuous back-and-forth flow of circles of communication and emotional signalling that comes at FEDC 4 and beyond. Once a child can be in this continuous flow, they are “cooking”.

Dr. Tippy says that for him it is all about the point where children reach the capacity to think in the abstract. The child’s ability to be in a continuous flow is a precursor to becoming abstract. They jump off FEDC 4 into abstraction at FEDC 5. And once a child is abstract, so many things change.

“Once you don’t have to run your entire life relying on your memory, things change.”

Dr. Gil Tippy

A child who is abstract knows that (s)he is a separate human being from you and that you have thoughts, ideas and desires that might differ from his/her own. So for Dr. Tippy, the action is all at FEDC 4 and 5. This is where the intervention is. We can do almost anything to get our children to FEDC 3, but if we don’t push to get them past there, they won’t pass the tipping point into abstraction. And as Dr. Andrea Davis pointed out, this can sometimes take years.

Quick Review of FEDC 4 and 5

Engaging Autism describes the six foundational functional emotional developmental capacities (FEDC’s) that are pre-cursors to foundational academics.

First is self-regulation and shared attention; next, engagement and relating, and third, back-and-forth communication or purposeful emotional interaction. These first three capacities are not difficult to achieve with most developmentally delayed children. The fourth and fifth capacities are where the most challenging work is that DIR/Floortime® addresses so well.

At FEDC 4, we are working on shared problem solving where we facilitate a child using long chains of back-and-forth emotional signalling with us to solve a problem with us. Following their interests, we can use techniques such as playing dumb to challenge the child to work to achieve something (s)he needs our help and is very motivated to do.

At FEDC 5, we work on symbolic understanding and creating emotional ideas where we help children attach needs and emotions to actions and words which is quite challenging for most children on the autism spectrum. We practice expressing emotions, model emotional expressions and help children express their emotions. Dramatizing and slowly adding in imaginary elements into familiar play can start to facilitate this capacity.

Dr. Gil Tippy often talks about instilling the spirit of inquiry into our children by making them wonder. We want them to wonder what it is that is in Mama’s head that she is thinking about, or what the parents are discussing in the front seat of the car. We can say things like “Hmm… I wonder why that man is getting on the bus? I wonder where he is going?”

Developmentally Appropriate Expectations and Limits for Our Children

We, parents of children with developmental delays, know how trying our children’s behaviour can be. It only feels right to be compelled to set limits. But discipline can backfire in serious ways that damage our relationship with our children. Safety and trust are critical to children who depend on us.

We need to learn how to set developmentally appropriate limits. Dr. Tippy says that whether or not your child is abstract yet determines everything. The following is true for ALL children, not just those with developmental challenges.

Pre-Abstract Child

Before a child can think in the abstract, it is pointless to focus on behaviour. As Dr. Gordon Neufeld argues, at this stage children are simply DRIVEN to behave emotionally. A pre-abstract child does not think rationally about behaviour. So a rational approach will get you nowhere.

Even if a child rationally understands that hitting is wrong, (s)he will not be able to stop his/her impulses. Dr. Tippy explains that “other people can be hurt” is a concept that is difficult for kids below FEDC 4/5 because it is hard to grasp that “you’re another human being who might get hurt.”

Physically stop inappropriate behaviour. If your child is hitting, physically move them from the person they are hitting and calmly say something like “we don’t hit other people” or “you hit me”. If they are throwing hard objects, physically stop them by taking the objects away or bringing them in another room while calmly saying something like “not for throwing” or “you hurt me”.

Focus on the connection with your child by looking at the child’s motivation behind the behaviour and assume all behaviour is purposeful. Was the child hitting because they wanted to play, but didn’t know how to appropriately ask to join in? Was the child trying to have fun and that was the only way (s)he knew how? Show them a more appropriate way. It may take many attempts.

Time-out is just punishing. Since the child has no concept of why what they did was inappropriate and is unable to control impulses, time-out is simply a punishment and time alone where we should be interacting with the child to help them.

Abstract Child

Once a child is abstract, so much more is possible. Dr. Tippy explains that after a child is abstract, you can simply raise an eyebrow and show disapproval and a child gets upset. At this level, time-out is much more about having to reflect on the fact that my mother is not happy because I have violated societal norms. This is where a time-in, as Dr. Greenspan discusses in Engaging Autism, can be really helpful. We reviewed some of these concepts a few weeks ago.

Behavioural Compliance

We have talked a lot in past blogs about the differences between a developmental approach and a behavioural approach to children and their problem behaviour. Development happens. If we work to move our children up the developmental ladder in the context of a safe, warm and nurturing relationship as discussed regularly at Affect Autism, behaviour adjusts itself accordingly.

Compliance does not guarantee appropriate behaviour. If a child does not “sign the social contract”, as Dr. Tippy says, then what happens when you are not around to ensure compliance? We have greater aspirations for our kids. We want the child to intrinsically be motivated to behave in socially appropriate ways. This only happens with appropriate development.

Tricks will backfire. It’s easy for parents to grab on to tricks here and there to help them with their children, but development takes time. It isn’t easy, and if anyone knows it we do. Troubling or inappropriate behaviour takes its toll on parents. But using tricks like threats and punishment to gain compliance only backfires. It is hard work to facilitate healthy development. It is never an easy fix.

Respecting Autism

Respecting autism is all about being connected. What is your child interested in? What is going on here? What brings your child joy and why? When we look at a child through a different lens, as Dr. Neufeld talks about, our perspective completely changes. Our child is not about his/her behaviours.

Please read Dr. Tippy’s book with Dr. Stanley Greenspan, Respecting Autism, for specific case studies of how his team applies the DIR/Floortime® developmental intervention at the Rebecca School in New York City.

Josh Feder, M.D. of the DIR/Floortime Coalition of California puts it this way: “Children are human, with motivations and desires. We want to tap into their emotionally meaningful experiences, joining them in their world so that we can entice them to join ours so that when they respond to our requests it is from mutual caring.  Compliance is what prisons expect of prisoners, relying on threat and leaving the person unable to move forward.”

Even the Abstract Child Can Retreat

Being a child who is abstract says nothing of situational variation. Just like us when we are upset or dysregulated for some reason, our child can also retreat from abstraction. We fall developmentally in the moments where we lose emotional control or our ability to stay self-regulated across people or situations.

Even adults who can function at the much higher developmental capacities can have emotionally catastrophic reactions to certain events, people, or situations. This is sensible and this is human nature. As Dr. Tippy points out, you wouldn’t treat someone the same way the day her mother died as the day she wins the lotto.

People get simplistic with kids with neurological developmental challenges, he says. It’s not true that once you conquer something, you have finished with it. People are always moving up and down the developmental ladder. So we wouldn’t want to have the same expectations or set limits the same way with an abstract child if (s)he is not abstract in that moment. That doesn’t work with someone who is dysregulated in the moment, Dr. Tippy says.

 

Hopefully you found this blog post helpful in understanding how to focus on development rather than behaviour when setting limits and understand that all of us can have capacities and potential that are at a higher capacity than where we behave at any one particular moment in time. Next time we will talk about moving up and down the developmental ladder.

 

Until next time… here’s to affecting autism!

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