This is a video Will and I made a few days ago. It's a good representation of what it is like to interact verbally with Will. It may not seem like it, but this is a VAST improvement over what it was like to try and talk with Will a year ago when he was first diagnosed with ASD.
For the last several months, Ashley, Will and I have been in a program called Parent Child Interactive Therapy (PCIT). It is offered through the county health department for families who have children with special needs including communication or behavioral issues. The principles can be applied to a variety of settings and even with kids who aren't special needs. In even a few short months, we've seen some great improvement not only in Will's communication and behavior, but it has also helped us learn how to interact with him in more positive ways.
Will reenacts the Pixar short film "Mater and the Ghost Light"
Every day at home, one of us has one-on-one playtime with Will called "Special Play Time". We usually do it after dinner while the other parent is putting Felicity down for the night. We put away all of Will's other toys and get out his box of Special Play Time toys that he only gets to play with during SPT. We set a timer for five minutes and Will gets to lead the playtime however he wants as long as he follows two rules: 1. Stay in your seat and 2. Play gently with the toys.
During this five minutes, we are to follow the "PRIDE" method which I will outline here:
PRAISE: Give a much praise as possible when Will follows directions and obeys the rules of Special Play Time. This can be labeled ("Good job staying in your seat") or unlabeled ("Way to go"!).
REFLECT: When Will makes a statement that is true or correct, reinforce that he has said something right by repeating it with emphasis on what he said that was true. ("The car is blue." "The car IS blue!")
IMITATE: Reinforce good behavior by imitating what Will does. For example, if he is humming quietly to himself rather than making a lot of noise, hum in a similar fashion. Make the same animal sounds that he is making while playing with animal toys.
DESCRIBE: Narrate what Will is doing, how he is playing with his toys, what he is saying, etc.
ENJOY: Have fun with it and try not to get so caught up in the rules.
Felicity was apparently annoying Will so he boxed her in with pillows.
Doing these things sounds pretty easy and doable but there are also a few things that you have to avoid. For starters, you can't ask ANY questions. If you need to get information from Will, you have to phrase it like you are thinking out loud about something ("I wonder what toys we are going to play with tonight..."). You also can't use any words or phrases that sound like you are directing the play or trying to control Will's behavior. This is words like "Stop", "No", "Quit", "Don't" and "Let's do (blank)".
If you watch the video again, you'll notice that I am trying to apply some of the things I'v listed above even though it's not during Special Play Time.
1 I described him poking his head
2. I imitated AND praised his quiet humming to himself
3. I attempted to use the "I wonder" phrasing to get an answer out of Will twice before finally breaking down and asking an actual question (which he ultimately answered)
4. I successfully avoided saying many of the forbidden words and phrases.
The "homework" portion of PCIT is only half of the program. The other is a weekly observed Special Play Time. This takes place at the therapist's office in a room with a one-way mirror. Ashley and I alternate from week to week taking Will. The therapist asks us questions about Will's progress since the last visit before leaving the room to observe Special Play Time for five minutes. After five minutes she starts to coach us on how we can better apply the principles during our play. She does this through an earpiece we are wearing while we play with Will. Afterwards, Will gets to eat a treat (usually he picks Cheez-its) and we get a score on how well we did during the observed five minutes and we get advice on what to do at home. Once a week, another therapist comes to our house and observes Special Play Time to see how Will does on his own turf.
Will has converted my old Ghostbusters toys into containers for holding Cheez-its.
The therapist always reminds us that we're only required to follow the PRIDE method during Special Play Time but if we find ourselves incorporating it into our regular interactions with Will, that is perfectly fine. We've taught Ashley's parents and siblings the PRIDE method and pretty much everyone in the immediate family uses "I wonder" statements when they are trying to ask Will something. It all sounds crazy BUT IT WORKS!!! Will rarely answers a direct question, but if you rephrase it as an "I wonder" statement, he somehow feels more compelled to response.
I think the most amazing part of all this is that Will now starts conversations with total strangers even if they aren't following the rules of the PRIDE method. We were at a park playground on Saturday and Will probably said hello and hugged five random kids he had never met before. One of them was probably 2-3 years older than Will and seemed a little weirded out by Will hugging him. When Will sensed that his new friend wasn't reciprocating and wasn't saying anything, Will looked him in the eye and said "Can you talk?" I know Will had classmates in preschool who were nonverbal so it was interesting to see him try to understand why this peer was not interacting with him either verbally or nonverbally. Furthermore, it was encouraging to know that Will WANTED to interact with another child that badly.
Will (left) climbing on the playground equipment with one of his cousins.
In my last post, I reviewed Will's strengths and weaknesses. A year ago, social interactions and verbal communications were two of his major weaknesses. They still aren't strengths, but it is encouraging to see the progress he has made in these two areas. It is also exciting to see that through PCIT, I am actually contributing to Will's positive growth.
Speaking of strengths, Will has really kicked his reading skills up a notch lately. He found my old Calvin and Hobbes books and now likes to read them out loud before bed. Here is a video of him reading one recently.