Education

Three Months Teaching An Autistic Child

I had never taught an autistic child before so when I was told I would be working with seven-year-old Sean (not real name), accompanied by a child-care worker, on a withdrawal basis for one hour a day, I was more than a little apprehensive.
At the outset some of Sean’s behavioural problems were outlined to me by his class teacher, the child-care worker and the psychologist who had assessed him. He threw tantrums. He became fixated or obsessed frequently. He didn’t play easily with other children. If for example he went to join a group in the yard, instead of playing the game, which he seemed to take no interest in, he would kick or even try to throttle a child. The end result of this behaviour was naturally, that other children were not too keen to play with him. Only the week before, I was told, his teacher took her eye off Sean for one moment, as the children stood in line, and when shoved accidentally, he lashed out with clawed hand at another boy’s eye, blackening it in the process. He had on occasion bitten children and teachers. In terms of class work he wasn’t too far behind the others. (In fact, I was surprised at how much language he had, for although I knew very little about autism, I was aware that autistic children often have little or no language.) The real input needed from resource was in social skills training.

The Routine

I decided to divide my fifty minutes into three. For the first fifteen minutes or so, I would do circle work. The next quarter of an hour we would play a board game and finally in the last twenty minutes I would read Sean a story and we would act it out.

The Circle Sessions
Circle sessions had worked very well in St Anne’s, a unit for disturbed children where I had worked for a year. The group in St Anne’s was much larger, up to twenty children or more, but nevertheless I expected this activity to work with the smaller group. It didn’t.

Kate, the care worker, myself, Sean and one other boy would sit around in a circle, with a rotating chairperson every day. Each would be asked in turn if we had anything to say. But Sean refused to co-operate. Either Kate or I had to place ourselves between Sean and the other child, a Down Syndrome boy called Tom, for otherwise he would scrape Tom’s face or try to hurt him in some way if he got a chance. He was constantly messing, kicking off shoes, sliding off his chair etc. He wasn’t engaged: it wasn’t working. So I dropped the idea of having chairperson and also sitting around in a circle. Instead we sat at the table where later we played the board game.

Expecting the children to come up with something to say every day was also a non-starter. Sean invariable ended up telling us the same rambling tale about a robot from a favourite television programme. So I changed the format slightly again, this time focusing on a different topic every day. I would start the ball rolling by telling the group who were in my family, my favourite food, what I had for my breakfast etc. The others took their cues from me. But this too ran out of steam.

Finally for this first session I came on the well-thought out Sunny Streets programme, the Chatterbox series, an oral language programme with lots and lots of ideas and activities and songs and mime. This worked very well and I have managed to adapt it successfully. Initially, though, there were problems. In fact, I discovered that any activity that was done away from the confines of the desk was open to Sean acting up. For example, one day I decided to play the beanbag game. I wrote our four names on the blackboard. Then we took turns throwing beanbags into a container. The one with the most success with getting beanbags into the container was the winner. Sean rubbed out the names, pushed Kate, thumped Tom and took no interest in the aim of the game nor wanted to learn. A ball game we tried another day ended similarly. Sean, when he had the ball, wouldn’t throw it to any of us but each time would simply throw it as far away as he could. I decided that there might be too much going on, too much perceived disorder. So when it came to our practice with playing Tip, I was determined to simplify.

Tip

Tip is a popular game played by children everywhere, simple to play and with no equipment necessary. One child is It. He runs and tips another child and that child is It until he can tip someone else. But Sean couldn’t play Tip. He had to be constantly monitored in the playground. I decided to teach him how to play Tip without becoming violent.

We would take it step by step. To start with, we did a little exercise in the room. I said: ‘Tomorrow, we will go out to the yard and play Tip, but first we’ll do it in here. Now, I will tip you very gently on the arm, Sean. Now I want you to tip Kate and say Tip. Kate will tip Tom and say Tip and so on.’ We did this a few times. Sean thumped Kate’s arm at first, but we said no, just a gentle tip and after coaxing he did it.

The next fine day, we went out to the yard. I put four markers on the grass and we each stood on our mark, a few yards apart, with Kate and I in between the two children. I ran and tipped Sean and said Tip, giving him a gentle tip on the arm. Sean ran to Kate, tipped her on the arm and said Tip, and so on. Sean tried to mess, butting Kate once or twice but he was corrected. Also, when he tried to leave his spot he was pulled up. We followed this procedure for a few days and it was a success. The boundaries were very clear. Sean seemed to understand exactly what was allowed and what wasn’t and more importantly, he seemed to be enjoying it. Next step would be to have the two children play tip without the adults taking part, but again with an adult at each post with a child to monitor that it was indeed a Tip and not a thump or worse.

From the Chatterbox series I started with the session where the children stand in front of the teacher. She says touch your toes, touch your hair, touch your shoulders. They do whatever the teacher says. Then she plays Simple Simon. The point about Simple Simon is that the children must do what Simple Simon says even though teacher might be doing a different action. For example, Teacher says Simple Simon says touch your toes, and she touches her hair. The children must touch their toes, not their hair.

Another activity was Giant steps, baby steps. I adapted this into a game, where I was the Giant and the children were the rabbits. They had to follow the Giant and try to overtake him, but if the Giant turned around and saw any faces they were out. This was a big success, and Sean took part in this very well, throwing himself to the ground and hiding his face when the Giant turned around. I felt at last I was finding a way to make movement activities work.

The Board Games

At the start neither Sean nor Tom really had a concept of winning, losing, your turn, not your turn, next person’s turn. We started with Snap. Neither of them knew what to do if two matching cards turned up. I had to teach them to look out for the matching cards and to say Snap, at the same time as placing a hand on the bundle of cards in the middle of the table. It took Sean a while to learn that you must do both simultaneously. Also, it was clear at the start that neither of the two were experiencing the excitement one should nearing the end of a game when there are only two players left. Sean was totally absorbed by the pictures on the cards. He would become fixated by a particular picture and then would try to engage one of us in a conversation about the picture, the game having been pushed into the background. If we resisted or moved on, he would work himself up into a tantrum.

Gradually he got the idea after about six weeks of playing the game weekly. He began to spot when it was Snap and he began winning. However, the other little lad, who was slower on the uptake, started to get annoyed that Sean was now winning frequently. So Kate and I had to slow motion the second matching card to draw his attention to it, so that he might say Snap.

There is an interesting sequel to our practice of positive discrimination. One day I had Sean on my own and we were playing Snap. By this stage he was much less likely to be fixated on the pictures and he followed the game with reasonable interest. He spotted when two matching cards came up and said Snap. I said Good Boy, you’re winning now. So we played on. The next time he had a card matching the one on top of the bundle, he mimed in very slow motion drawing my attention to the fact that something was coming up, just as we would have done for Tom. He almost put the card down, but then put it back on his own bundle and again in slow motion exaggeratedly put it down very slowly, but stopped just as he reached the bundle in the middle of the table. Back on top of his own bundle again. He did this two or three times and eventually put it down on top of the bundle on the middle of the table. I waited until he said Snap with his hand over the bundle before I said Snap. He put on an expression of sadness. But you should have said Snap, he said. I did say Snap, I said, but you were quicker. I should have let you say Snap, he said then. He clearly had the concept that manipulation to help the less speedy was part and parcel of the game. I resolved to play the game straight the next time. Time to end positive discrimination!

Role Playing

The role-play sessions were a success right from the start. The first thing Sean would say to me every morning would be: will we play the game? His face would light up when I’d say yes. Which one? he’d ask then. We’ll choose later. And he would be happy with that, secure in the knowledge it would happen.

When the time would come, I would read a story to Sean, then he and I would decide which character we would each be and we would act out the story. Most of the time I had a few roles to play, and of course I was always the Baddie, whether the wicked Troll, the bad fox, or the scary bear. The room, a small library I was allocated, was cluttered and much too narrow for this activity, but we managed. We acted out The Sly fox and the Little Red hen, The Enormous turnip, Hansel and Gretel, (although I had reservations about the sexist theme at the heart of this story), Granny’s Teeth, Rosie’s Cake and many others. As time went on I was beginning to get some insight into Sean’s psychology, into how things affected him. He loved the idea of being really scared and then feeling safe. There was one particular book that he loved, one of those marvellous giant storybooks that are so popular now. This book was called Eddy and the Giant Bear. Eddy goes into the woods to find his teddy, Freddy. The woods are scary and horrible. Because the book is so large, the pictures of the woods have a very realistic and eerie look about them, and every time we would start at this page, Sean would say, wait a minute, its very scary, isn’t it, delighting in how scary it was, nudging up close. Eddy goes further into the woods and each step brings him nearer the Bear. Sean would insist I speak the words as ominously as possible so he could experience completely the feeling of being scared. Then as the story reaches its denouement in Eddy’s favour, and the bear doesn’t eat him, Sean would relax. He had savoured the story to the nth degree and he now felt safe and satisfied. He wanted this story read to him and acted out over and over again for weeks and weeks.

I came to realise how significant this reading and role-playing session was for Sean. He was able to act out a variety of emotions, particularly emotions of anger, fear and relief. Given his tendency to extremes of uncontrolled emotions, tantrums, rigid rage, obsessive fixations, acting out these scenarios were very important. He could see that it was only a story, something apart from him. He was learning about how he felt in different situations, through the stories. Knowing when we feel scared or angry has to be the first step in getting control of emotions that are out or control.

Conclusion

When I was first appointed to this job I saw it as a challenge. I was very keen to see how I would adapt and work out a programme that would help Sean develop. As the weeks went by, however, and I experienced his rages and tantrums, I became very discouraged, because I felt helpless to do anything with him in these situations. I came to dread that first session every day. I simply felt I was a failure. Its a chastening experience for any teacher to feel a failure, for it gives an insight into what many children feel when they have impossible tasks to undertake. A lot of what I was doing was experiment, trial and error. There might be no results for a long time, if at all. No one had given me a programme that was tried and tested. There was no blueprint, no guidelines. I was on my own.

As a resource teacher, I was allowed two hours every week preparation time for my nine pupils. Much of that time was spent thinking about Sean and how I might develop a better programme for him. In fact, after the Halloween break, such were the tantrums he had thrown the week previously, I absolutely dreaded going back to that school. But then, gradually, very gradually, I was starting to hit on the things that worked. The board games were working, he was learning to take turns, learning to watch the games and become interested in what the games were about. The Tip sessions were working well, the other Chatterbox sessions were beginning to work, and the reading cum role-play session was a big success. When we said good-bye to each other at 10 a.m. there were no bad scenes now. He was relaxed, and so was I. I no longer dreaded coming in. In fact it had become a challenge once more, but one I felt up to now.

When the inspector told me I would no longer have Sean after Christmas, due to a re-shuffle of resource work, I felt regret. Sean’s mother told me Sean was beginning to play games at home, taking turns etc. She said she regretted my leaving, which I really appreciated, given that I felt her anxiety so keenly in October, when things were not going well. Working with Sean was exhausting at the start and very difficult but in the end it was an exciting session. I was now coming away from the sessions energised. And I felt Sean was too. The whole experience with working with this autistic boy has been a lesson to me. I had almost given up. The key thing is though, that I didn’t and I know that Sean developed in however small a way because of that. And the truth is so did I.

First published in InTouch 2000