Autism Therapy: self-stimming

It seems likely that many if not most nonverbal or low-communicating children with autism can read by the time they are six or seven, sometimes earlier – even when no one has taught them and even when no one knows they can read. I have observed this time and again and professionals who work with nonverbal children/people with autism using literacy based methods have confirmed this observation. It is hard to imagine the concept at first - that a person could know how to read and yet not know how to communicate, but it turns out that it is probably somewhat common in this population.

Recently a member posted on my community forum (www.strangeson.com) about reading and how colorful picture books kept her child’s visual interest. I thought I would share a few thoughts on this and in particular differentiate between a child/person’s visual interest and auditory interest in books.

There are several ways a child/person you are working with can respond and relate to books. Visually stimulating types of books designed for very young children can capture visual attention and they can be fun and useful for keeping a child/person focused on a visual target (in this case the pictures in the book) and this can be used for social interaction as I will describe below.

For educational purposes on the other hand, we need to remember that many nonverbal children/people with autism are very reliant on their auditory system for learning. I remember asking Soma when I first met her, how she got the idea to read books aloud to Tito when he was little, even though he showed no outward sign of paying attention to her words much less understanding what she was reading. She called it “listening behavior” and explained that he could have left the room, but he never did. I realized when she told me that, that when my husband read Harry Potter aloud to the kids and Dov was running around the room, making sounds and stimming and acting like he was paying no attention – he never left the room either – and he could have. Most of us think that “listening behavior” consists of sitting quietly and attending to the pages of the book, but Soma taught me that not leaving the room was listening behavior too.

Later, when Dov began to communicate, it turned out he had been listening all along and he could answer all kinds of questions about Harry Potter from when his Dad used to read it aloud. You can read a few sentences or a paragraph of age-appropriate material, whether from a teen magazine or the newspaper or a book and then ask a question and use multiple choices to get the answer, then read some more. If the child/person stays in the room – you can be pretty sure he/she is listening, even if he/she displays none of the behaviors such as sitting quietly and looking at the pages.

It’s gotten to the point now that Dov knows it bothers me when he starts stimming too wildly while I am reading to him, and so when he does it I just stop reading mid-word and give him a quick look and he stops immediately – because he loves to listen to someone reading out loud! Then I resume reading immediately. Now Dov can sit for hours listening and answering questions and asking them too and I’m the one who usually tires out first.

But Dov also still loves to look at his favorite, visually exciting type of books with high contrast colors and designs, and sparkly illustrations; books for very young children. These kinds of books definitely still capture his visual attention and when he is paging through one of his favorite “visual” books, sometimes I take the opportunity to talk about the pictures with him, and discuss what he likes and why. Dov can spell out a word, phrase or sentences about the pictures in these books but in the beginning we often used multiple choice and even now, if he is tired or having a hard day, we might still use multiple choice sometimes.

An example of how you can use multiple choice with a picture book to turn visual fascination into communication, you could ask: “I see you like this page. What do you like about it?” then I quickly jot the choices on a clipboard: “the way it looks?”, “the way it feels?”, or “both” and “something else”. (I always include “something else”) If he/she chooses “the way it looks” you could ask: “What do you like about the way it looks?” and offer the choices: “the colors?”, “the sparkliness?”, and so on. You could also ask him/her to show you the part of the page he/she likes best (by pointing) and then talk about that, ask more questions, and so on. This is a fun activity and it gives you a chance to share something the child/person likes and have an interaction about it - which most kids/people with autism don’t get a chance to experience often enough. But it is also a completely different kind of activity than reading a book for the sake of learning about something and/or for the literary enjoyment.

Both kinds of activities are very valuable. Enjoy!

Best wishes, -Portia