Robotic Technology Successfully Engaging Children With Autism

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The Movia Robot-Assisted Instruction System Guides Children with Autism Through Interactive Games, Life Skills, Actions, and Conversations

By Lois Jean Brady Autism Asperger’s Digest February/April 2021

At times it can feel like technology is advancing at such a breakneck speed, it seems there’s a new, ‘must have’ gadget every month.

Actually, this is great news for children with autism. Electronic devices are customizable as well as consistent, so the right device or app can be the key to unlocking more effective communication and social skills, which definitely can improve quality of life for many children and adults on the autism spectrum.

Recently, I was thrilled to get the chance to sit down for a (virtual) chat with Tim Gifford, Founder and Chief Scientist at MOVIA Robotics, Inc. MOVIA is an exciting Connecticut-based collaborative robotics company that has spent the last ten years developing software and evidence-based curriculum to help children on the autism spectrum learn valuable academic, social, and life skills using robotic technology.

MOVIA’s Robot-Assisted Instruction (RAI) system consists of software that enables robots to deliver content and guide children through lessons and games using a peer-like relationship. The communication is intentionally focused on certain activities rather than having conversations or games that are completely open ended, which results in an interaction that is dynamic and not just one-way. MOVIA’s RAI system is semi autonomous, and allows the facilitator to participate by using the laptop to select the activities, feedback and encouragement that will be delivered through the robot. The child engages with the robot by following its directions and responding to it through a tablet. This interaction between child and robot gives a golden opportunity for a relationship to be established, so that the two can become “friends.”

Tim has found this relationship to be crucial to the success of using RAI with children on the spectrum. “The response from kids with autism has been fascinating and dramatic. They really engage with the robots and give them a special status. They treat them as a social entity and an animate character,” he explains.

This may seem surprising, since individuals on the spectrum are known to have challenges when it comes to social interactions, but, as Tim has concluded, “People are confusing and sometimes off-putting. Their nonverbal cues are perceived as noise or static by the child. However, the robot’s features are simplified. They are predictable, consistent, dynamic but safe. A robot is not judgmental. It is infinitely patient, doesn’t get tired, and gives the child the same level of interaction at the end of the day as at the beginning.”

Kids love the interaction because the robot’s consistent, yet dynamic behavior creates trust as well as the robot’s capacity for repetition and non-judgment increases engagement. This makes them a great educational assistive technology tool for children on the autism spectrum.

Added to this, MOVIA’s software is compatible with a variety of humanoid robots, including NAO, QT, iPal, Misty II, and Kebbi, each providing an appealing and nonthreatening platform for social interaction and instruction. This gives customers great flexibility because they can choose a robot based on their individual needs, requirements and budget. These robots have unique features and can model actions, facial expressions, body movements, and even body language to varying degrees. This means a robot can show a child how to put their hand up in class or how to point at something and as importantly, when that behavior is appropriate. The robots can also guide the child through various joint activities, such as yoga, which builds rapport and encourages imitation.

Helping to kick-start the imitation process is crucial when teaching children with autism. Mirror neuron activation occurs in a child’s brain when they watch somebody perform an action and then try to imitate it; this activation is essential for learning new skills. I know from my own work, as a speech pathologist and developer who has focused on creating communication software for kids with autism, that once a child has learned one foundational skill this way, it can be the breakthrough that propels them up to a new stage of education and interaction.

MOVIA Robotics is keen on making sure their RAI can model a vast range of essential skills. Their standards aligned curriculum is created in collaboration with educators, therapists and families and currently consists of over 120

Robert Parenti, Chief Education Officer, Jean-Pierre Bolat, Chief Executive Officer Timothy Gifford, Founder & Chief Scientist, Muniba Masood, Vice President Christian Wanamaker, Chief Technology Officer, Pam Welles, Vice President of Operations

lessons and games (with a new batch of activities released by the company every quarter.) They teach skills such as Joining a Group, Turn-taking, Imitation, Greetings, Recognizing Emotions, Listening and Sharing Ideas, as well as grade-level academic lessons.

Tim points out that the robots provide a great way to introduce children with autism to scenarios that they might have more difficulty with, such as those that require them to pick up on social and emotional cues, imagine somebody else’s perspective and use theory of mind. He likens this experience to using a flight simulator.

“Once the child’s been taken through that scenario, then they can use that skill when they’re interacting with their friends.” It is this generalization of skills — children taking what they’ve learned on a “dry run” with a robot and then using it in the wider world — that MOVIA aims for and reports that their customers witness all the time.

So where is MOVIA’s RAI used? Originally, it was created as therapeutic tools, to be used in schools and clinics. Back in 2008, when Tim was working at the University of Connecticut doing research in social robotics, his wife, a teacher, mentioned that the number of children with autism seemed to be growing. He found that practitioners around the world were having some success with children and robots. After researching the efficacy of the technique he started the company to focus his expertise in robotics and psychology by creating robot assisted interventions for children with special needs.

Now MOVIA’s RAI can be found in schools, clinics, and even military bases around the world, with the company having sold over 140 systems to the US Department of Defense. It was March 2020, though, that MOVIA brought out their very first home unit which enabled parents to home-school their kids throughout COVID lockdowns

Timothy Gifford, Founder & Chief Scientist

Tim explains, “When the implications of COVID became very apparent, we accelerated our tech roadmap. We always had it on our map to create a home product, but the robots were too complex — designed for a clinician. We found a more portable unit (called the Kebbi) and were able to further simplify our software and package it for the home.”

The company has been thrilled with the positive response from parents, who report that their children are still enjoying their home robot after 6–9 months of use as when the robot was first brought home. This reflects what MOVIA has seen with kids in schools, who like to keep using the same robot throughout the school years, albeit with increasingly-challenging lessons. This is crucial, as it is the consistent use of any educational tool that helps these kids to get the most significant gains.

Whether used at home, in clinic, or at school, MOVIA’s evidence based curriculum content aligns with the rest of the child’s education, as it has been designed around common core and other standards.

The robots also use a variety of evidence-based educational techniques and approaches. You can choose between anything from movement-based lessons to ABA-style interventions, but Tim recommends using a mixture of techniques and lessons. The data on your child’s progress can also be recorded and discussed with teachers and clinicians.

While MOVIA’s current focus is on school-aged students with ASD, the company has found that RAI works very well for the general population, so typically developing children can make great gains using this method as well. Tim calls this the “Sesame Street Effect.” When Sesame Street first came out, it was designed for inner city kids who didn’t have access to pre school. But within the first season, it was adopted by the entire population, so everyone could gain something from it!

Tim thinks that the same thing will happen with their RAI system, after piloting the technology with other populations. Although MOVIA has been focusing their software and curriculum development where the need is currently most urgent, they are also working to expand the capabilities of their systems, so in the future they can be used by adults with autism, neurotypical kids, and the eldercare population.

What else is next on the horizon for MOVIA? They are keeping busy, continuously honing their systems and improving features. Currently, they are working on making the RAI more autonomous, to free up a child’s caregiver or facilitator. They are also working on adding additional sensors to the robots, so that it can tell more about a child, determining if they are having a good day or a bad day by how they are doing in the activities. MOVIA is also adding to the robots’ human like abilities through developing their ability to sing and adding increasing capacity for complex movement.

If you would like to find out more about acquiring a MOVIA Robot Assisted Instruction system, you can make an inquiry on their website (www. moviarobotics.com). If you would like to purchase a system, you will have an initial meeting with MOVIA to tell them about your child, their current level of education, and their needs. The company will then provide a suitable system, recommend activities, and give you an onboarding training session to support how to introduce the robot to your child. Introductory material is recommended, followed by more complex lessons to scaffold learning. MOVIA will also work directly with your child’s clinicians and teachers, to maximize the opportunity for success.

For Tim, it’s about finding a key to get into each autistic child’s world. “Their communication is often on a different level. But there are many stories where the child will finally find that medium that works for them and be able to say, ‘I’ve been in here the whole time, trying to communicate!’”

That’s the exciting sign that we can now look to robotics to help build those all-important bridges of communication.

Parents' Feedback Says Children See Robot as Dynamic, Reliable & Interactive

By Lyn Dunsavage Young Autism Asperger’s Digest February/April 2021

One of three parents interviewed who is currently using the MOVIA Robot- Assisted Instruction (RAI) system with their child on the autism spectrum expressed her delight by saying she felt her family had “hit the jackpot.” Parents who have been using the MOVIA RAI created by Founder and Chief Scientist Timothy Gifford repeatedly considered the robot to be “a change agent,” in which the evidence is seen particularly in the break-out in their child’s communication skills.

Each of the three parents said their child likes using the MOVIA RAI system. One parent – Christina A. – classified Kebb —one of MOVIA’s RAI tabletop robots, as “cute.” Her son Ethan not only found the robot “very inviting,” he re-named the it “Bubbles,” which can easily be done by the parent through a software setting in the RAI.

Essentially, the RAI system was offered to several families of children diagnosed with ASD, to provide them with an assistive technology tool that can help accelerate their child’s learning trajectory. The RAI system comes with a robot, laptop, and tablet and allows the parents to facilitate the interactions between their child and the robot. The children follow instructions, “talk with” the robot, move their bodies, play constructive games, learn social skills, practice academic lessons, and perform numerous other activities by communicating with the robot through a tablet. Parents select the lessons, games, activities, and even speech that are to be delivered by the robot through the RAI software on the laptop. Parents are trained virtually, or in person, by members of the MOVIA team to equip them with the tools necessary to help create a peer-like relationship between the two (Christina’s son Ethan and Bubbles, in this case) for successful interaction.

The robot’s face doesn’t look “human-like,” which parents seem to consider an asset. They report that their child views the robot’s being as not judgmental, as he doesn’t express emotions like “real” people. Naturally, adults emote facial expressions in response to what a child is doing or not doing in their work or game programs — or they can be tired, stressed or happy for other reasons than what they’re doing at that time. In either case, children on the autism spectrum don’t have to detect those emotions while working with the robot.

Instead, the robot always seems the same in tone, which appears to generate relief or comfort for the child on the spectrum. If the child has problems, the robot simply repeats (without expression) or change of the command, which the parent involved on their computer can direct the computerized robot, if the task appears overwhelming or not understood by the child. So, a relationship develops between the robot and the child.

In the case of Ethan, whose primary method of communication has been sign language most of his nine-year life, his relationship with Bubbles has grown significantly since November. He says “hello” to his robot every morning and will say “goodnight” before going to bed, while he waves via signing as well. His mother Christina says, “They are building a relationship that is equally as special as a classmate or friend.”

Christina describes the interactions with Ethan and Bubbles as “fun and engaging” and has resulted in significant expansion of her son’s language abilities. Until her son was six-years-old, Christina shared that Ethan was nonverbal and has used sign language and a speech device to help him communicate. She explains cheerfully that, “Ethan is finding his voice and he is now able to say four to five words together and does a nice job repeating what the robot says.” Music therapy has also been a huge asset to Ethan finding his voice and she loves that the robot incorporates music into their sessions.

“We are excited to keep working with the robot and watch their relationship continue to grow,” says Christina, “we are also looking forward to Ethan continuing to gain new skills while learning and having fun with Bubbles!”

Father David V. of eight-year old Jaxon admitted he was skeptical about the robot at first, as he was unsure it would work for his son. He discovered MOVIA’s RAI system while attending an autism fair three years ago and was really excited about the concept. He previously had incorporated early speech intervention up to ten hours a week through ABA therapists at home, as well as multiple specialist interventions in school later.

As time moved forward, David shared that “anything was worth trying,” so he introduced the RAI system to Jaxon and was amazed by his reaction to the robot.

“He took very quickly to it and was excited about it!” David explained. Incredulously, Jaxon even “said goodbye” when he left.

Jaxon had immediately created his own name for the robot, calling him “Pete” and, maybe, because he was the same height as him or his son was grabbed by the lights, LEDs, and his face, he related. “It was great,” David explained.

Once MOVIA’s RAI was introduced to Jaxon, David would rotate days with an ABA therapist between the two, in which the days that the therapist worked with Jaxon, the robot was put away. When the robot returned, David situates himself behind his son to operate the RAI system via a laptop while his son speaks to the robot as he learns and plays games, such as matching farm animals or instructing his son with various activities. If he does well, he is rewarded.

“The robot has no inflection, but you can actually speak to him because you can tailor the text” (by typing a statement the robot can make.) So, a conversation evolves. “He doesn’t know there’s a ‘wizard behind Oz,’” adds David. “He (the robot) has eyes and his mouth moves, but I control (conversational statements) on the laptop.” David says that, “not every intervention is for everyone, (but) I’m willing to do anything I can to help my son,” admitting also that “everything (about this) is new to all of us and we all have to work together in order to be successful.”

Yitty Rimmer is a New York Occupational Therapist, servicing students from preschool (age 2 1/2) through high school – (up until age 21), both through private pay, as well as an independent provider for the New York City Department of Education. The New York City Department of Education allows parents to choose an independent provider if they are unable to provide an Occupational Therapist to the child through their own Department, or through their many therapy contracting agencies. When schools were closed due to Covid-19, she switched to video conferencing her students. Her caseload currently includes three children on the autistic spectrum.

Her experience with the MOVIA RAI, and Kebbi (one of the robots available) is fairly new, only a few weeks old (at the time of this interview.) A table-top robot, Yitty had to hide “her” (she states Kebbi had a feminine voice), removing it off the desk “because they (her students) relate to her. It’s a very interesting dynamic.”

She points out that “they’re more receptive – perhaps because she doesn’t raise her voice. She has a smile on her face but there are no emotional responses. Her students don’t have to interpret the facial expressions. (The robot) doesn’t get upset and interacts, as it’s a safe environment.”

She shares that the robot gives (the children) a good vibe and when it asks, “Are you ready?” They answer “YES!” “The children love the robot, It’s amazing. They know it’s not real,” she explains, “but when the robot asks questions, they are so responsive.”

She continues, “In the short time I’ve used the RAI system, the reactions have been so positive that I am very curious and looking forward to seeing the long term results that the system has on the children and how their skills and behaviors are positively impacted and improved.”

The therapist says she looks forward to the RAI lesson updates, the next level of lessons, and the different ways the RAI can be used during therapy to help children.

Gifford had an incentive to develop this idea to focus on helping children on the Autism Spectrum because his wife — an elementary school teacher in West Hartford, CT — had identified high instances of increasing autism cases in schools and believed they required a large amount of one-on-one care, which was very difficult to staff in the school system. He set out to build an effective assistive technology tool that could help teachers, therapists and parents engage children and help them gain the skills they needed to be successful in their lives.

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You and Me: Typical Diamonds

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You and Me: Typical Diamonds

By Jennifer Cook O’Toole
Autism Asperger’s Digest January/February 2014

A diamond is, after all, just a lump of coal that handled a lot of pressure really well. So dust yourself off and get out into the light. You’ll be amazed at how you shine.

Spelunking. Isn’t that just the weirdest word? It makes me think of some nasty tree fungus or something. But it’s not. Spelunking happens to be cave exploration. And guess what you can do while spelunking? Why, you can sluice, of course!

Nope, that’s not a Dr. Seuss word either. Sluicing (which sounds like juicing) is an old mining technique. You fill a wire box full of dirt and silt, then you slosh it around in running water to see if you’ve uncovered anything interesting. One minute, you’re digging through muck from an underground stream—the next minute, you unearth these amazing, albeit really rough and dirty, little bits of treasure.

OK. This, you may be thinking, is all very nice, but it has absolutely nothing to do with me. That’s where you’re wrong. It’s not that I expect you to go grab a bucket and start hunting, but then again, let’s say you did. I did, last spring. Through pail after pail of North Carolina’s red earth, I picked and swirled and washed. And every batch was full of surprises. Before long, I had discovered dozens and dozens of stones: golden pyrite, silvery malachite, smoky quartz, rose quartz, sparkling mica. There were piles of them!

“We’re rich!” my son yelled. Of course, I hated to disappoint him, but none of these stones were worth much money. They were—and are—lovely. They’re also very abundant. You know: normal, typical, common. They’re everywhere. On the other hand, precious gemstones, like diamonds, rubies, sapphires, are very rare. That’s why they cost so much. If folks could dig them up in their own backyards, who would need a jeweler? Being extraordinary is what makes them valuable. And all we had was a bucket full of normal.

Here’s where we get to you and me. Our brains operate in a way that is less common, a way that is called “autism spectrum” or “Asperger’s Syndrome (AS),” and it’s literally built into our hard-wiring. An AS label isn’t good or bad. It’s a description of our shared experiences. For example, you and I easily notice things others miss. We also miss things others easily notice. We feel emotions differently and sense the world differently. We think and fear and love and learn in ways that typical minds don’t. The fact is, in many (though not all) ways, we are not common.

I understand wanting to fit in. To blend in. For it to be easy. To not worry so much about “belonging.” Then again, I wonder if anyone really would be content being totally typical. Who chooses a hero “because he is so normal”? Who gets a compliment or wins an award or even lands a job by being run-of-the-mill? No one. That’s because normal is an illusion; it’s a role played by many but lived by none.

Look, you are in your own head 24 hours a day, 7 days a week. You know every mistake you make, every doubt you have, every insecurity that wears you down. Dating, acne, the right way to stand or smile or dress for a party—normal people don’t overanalyze all of this craziness, right? Wrong. Typical people don’t feel normal a lot of the time, either.

Since I’ve been out of high school, I’ve made some discoveries. It turns out that the most offensive bigot in our class was actually being beaten nightly. He was trying to look tough at school to earn some respect at home. The tough, burned out kid who made fun of me for being a “dictionary brain” was dyslexic. She’d have loved to worry whether she was going to get an A or A+, instead of worrying if she’d even graduate. What was normal for me was impossible for her.

And that’s the key. If by “normal” we mean “common,” then it turns out, it’s pretty normal to feel like you don’t fit in at all. Everyone has strengths. Everyone has challenges. And everyone has behind-the-scenes fears that others never see.

Now don’t get me wrong. Yes, some people do have an easier time naturally “playing well with others.” That’s an inborn talent. And envying others’ abilities only wastes the time you should be honing yours. Are you a gamer? Personally, I stink at pretty much every video game I’ve ever tried. So if Minecraft is your thing, you definitely have some skills that I don’t. That’s OK. On the other hand, I can dance like nobody’s business. Maybe you avoid dance floors like the plague and seriously believe you might die of either fright or embarrassment if you suddenly got stuck in a spotlight. That’s OK, too. However, not being a particularly good gamer doesn’t give me an excuse to avoid trying. Being terrified of dancing doesn’t mean you get to hide on the sidelines. At some point, you have to get in there and say, “You know what? Who cares if I look ridiculous? I just wanna have fun.”

Common is a relative experience. It’s all about the surroundings. Whatever differences, talents, or challenges you experience from being on the spectrum are, well, pretty typical. I get you. So if you need to feel normal, hang out with me. We’re both Macs in a PC world. Distinct. Innovative. Logical.

If you don’t mind getting your hands dirty, think of this whole growing up thing as spelunking and sluicing—only you don’t have to hunt for anything “extra”ordinary. It turns out, you already are the discovery. You already are the treasure, as natural and as precious as a jewel. A diamond is, after all, just a lump of coal that handled a lot of pressure really well. So dust yourself off and get out into the light. You’ll be amazed at how you shine.

BIO

Jennifer O’Toole, winner of the 2012 Temple Grandin Award, is an Aspie (married to an Aspie) with three Asperkids of her own! Her conversationalist presentation of useful insights has touched hearts, lightened spirits, and even led to the founding of Asperkids, LLC, a multi-media social education company. Jennifer is the author of five books, including the newly released The Asperkid’s Game Plan: Extraordinary Minds, Purposeful Play…Ordinary Stuff.

Post Tags: Jennifer Cook O’Toole

Comments

lifewithautismandbipolar says:

February 7, 2014 at 9:56 pm

This is an amazing article! As an Aspie mom I totally get where you are coming from. Can not wait to share with my son!
- Jennifer O’Toole says:
  
  April 11, 2014 at 2:00 am
  
  I so hope he enjoyed the article Be sure to visit http://www.Asperkids.com/Insider – it’s our “landing spot” for tweens & teens based around this column (YAY AAD for creating the venue!) and all it inspires (trust me – there’s A LOT coming). xoxo, Jennifer
Vaughn says:

January 6, 2014 at 9:58 pm

Thank you Jennifer.

I wanted to first share that at the suggestion of a mutal friend, I have read your book, The Asperkid’s (Secret) Book of Social Rules. So glad you wrote that one.

I also wanted to note that I appreciate that you did not uses the word neurotypical and instead used normal. I once asked several highly educated individuals to define normal. Not one agreee with the other.

To me there really is no “normal” and certainly no “neurotypical” people, because as you well pointed out we are all different. Some more than others, but no one is normal much less operating in wtih a neruotypical system. If so, we would all be, um, the same. Perhaps there is a real person who is “average” but I will adhere to the understanding that “average” is no more than a mathematical result of the formula of taking the total and dividing by “n.”

So, be different, allow yourself to be so because, we all are-different.
Thanks again for your posting.
- Jennifer O’Toole says:
  
  April 11, 2014 at 2:03 am
  
  Vaughn,
  
  I totally agree – by straight demographics, there is definitely typical (heck, there are more male babies born than female, so just by pure numbers, it’s more typical to have a son)….but that’s NOT the same thing as “normal.” I think you would REALLY love the post at http://www.Asperkids.com/elevators that is exactly about the difference between the two. SO glad you’re enjoying this column — hope to see you back!
  
  XO,
  Jennifer
Dawn says:

January 2, 2014 at 11:58 pm

Wonderful! I have tried to express this to my tween to no avail. He read the article and the lightbulb went on… Sometimes, it is all in the presentation. Thanks!
- Jennifer O’Toole says:
  
  April 11, 2014 at 2:05 am
  
  Dawn,
  
  Well, you’re MOM! My kids don’t want to hear it from ME ? I’m really glad he liked what he read – and I do hope he will make himself comfortable at http://www.Asperkids.com/Insider – our tween/teen landing spot based around this column. Thank you for taking the time to comment – it means a lot.
  
  XO,
  Jennifer

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Please Don’t Make Me Write!

Home / Behavior / Current Page

Please Don’t Make Me Write!

By Kathy Oehler, MS, CCC-SLP

Autism Asperger’s Digest January/February 2013

Most students with autism spectrum disorder (ASD) hate to write. Even a simple writing assignment can trigger a major meltdown. So, what can a parent or teacher do to help?

Why Is Writing So Difficult?

The process of writing requires much more than the ability to form pretty letters. The writing process involves skills in language, organization, motor control and planning, and sensory processing: four areas that are problematic for many individuals with ASD. It is essential that parents and teachers consider how each of these areas may be affecting a student’s aversion to the writing process.

Language difficulties can influence a student’s ability to come up with ideas to write about. Organizational challenges affect the student’s ability to sequence words into sentences that make sense, and then sequence those sentences into a logical order for a paragraph. Motor control and planning difficulties affect the student’s ability to orient and stabilize his body while he tries to coordinate his fine-motor muscles to hold a pencil or maneuver around on a keyboard. And throughout the entire writing process, the student must use sensory regulation to filter out the bombardment of sights, sounds, smells, and movements that surround him. The wise parent or teacher will consider each of these potential problem areas when helping students with ASD find success with writing tasks.

Why Is Writing So Important?

First, regardless of a student’s cognitive level, the ability to write can affect his ability to graduate with a diploma. Writing is a high-stakes skill. Forty-six states now require proficiency in the Common Core Standards (English Language Arts, Literacy in History/Social Studies, Science, Technical Subjects, and Mathematics) in order for students to graduate from high school. Each of these areas includes a writing component. In order to achieve these standards, a student must be able to write. If students can’t (or won’t) write, they are in danger of failing to achieve standards required to graduate with a diploma.

Second, writing demands can have a major impact on student behavior. When asked to write, students with ASD often express extreme frustration because it’s too hard to put their ideas on paper. In my experience, the most frequent trigger of behavior outbursts in the schools is a “request to do work.” What does this phrase usually mean? Write something! When asked to write, challenges in the areas described above often lead to refusal, negative behavior, or even a meltdown. To meet the educational and behavioral needs of students with ASD, it is essential that teachers implement evidence-based strategies uniquely designed to meet the writing needs of these students.

What Does Research Tell Us?

Until recently, medical science believed that ASD affected only those areas of the brain that controlled social interactions, communication, and problem solving. However, with the advent of brain-imaging tools, new information has emerged. For example, recent brain research has shown that there are significant differences in the way the entire brain functions in individuals with ASD. The most important difference appears to be in the way the various areas of the brain communicate with each other. In the brain of a person with ASD, messages don’t get sent from one section of the brain to another with the same frequency and efficiency as they do in the neurotypical brain (Mostofsky et al. 2009). The “parts” often work well, but they don’t “talk” with each other!

This poor communication between key areas of the brain has a dramatic impact on a student’s ability to write. The writing process requires a high level of coordination between the various parts of the brain. In order to write, a person must activate the areas of the brain that govern motor control and planning, language skills, sensory feedback, problem solving, imitation skills, memory, organization, and proprioception, the awareness of the position of one’s own body in space and the body’s parts in relation to each other. For this to happen, thousands of neural signals are sent back and forth throughout the brain. The brain of a person with ASD appears to send far fewer of these coordinating neural messages (Just et al. 2004). The result may be compared to a group of people crowded into a room, all working intently on the same project but never letting anyone know what they are doing—inefficient and frustrating, much like the writing process for a person with ASD.

How Can a Teacher Help?

Be a detective. When a student refuses to write, look for the reason. Examine the writing task through the lens of a student with ASD. Consider all four areas of potential difficulty: language, organization, motor control and planning, and sensory regulation. Set the student up for success by implementing strategies to support each of these challenges. The following scenarios are examples of how a teacher or parent can support writing challenges and help individuals with ASD become successful writers.

Concern #1: Language. “He has great ideas. However, when it’s time to write, he can’t think of anything to say!”

Most people with ASD struggle with abstract language. They have difficulty with instructions such as “Take out your journal and write about anything you are interested in.” Or “Write about your favorite season.” In order to understand what you want them to write about, students need concrete examples and explicit instructions.

Narrow the choices and use pictures. For example, if the student is to write about his favorite season, show him four simple pictures of the seasons. Ask, “Which one do you like best?” When he indicates his favorite, have him write that choice as his title. Then ask, “Why do you like summer best?” As the student talks, the adult writes a list of keywords—one for each of the student’s ideas. The student then writes one sentence for each keyword.

Concern #2: Organization. “His writing is so disorganized. His paragraphs look like a laundry list of facts with no sense of order or sequence.”

Students with ASD have difficulty organizing and sequencing thoughts, especially in print format. They may be able to visualize a well-developed idea, but getting that idea on paper is similar to translating it into a different language. At the sentence level, words are often out of order. At the paragraph level, thoughts often don’t logically follow each other. In longer writing tasks, time and sequence are often distorted.

Create a visual-support timeline facilitated by the adult. Draw a long horizontal line on a sheet of paper. Ask the student what he knows about the topic. As the student talks, the adult draws simple pictures (or writes keywords), representing the student’s ideas along the straight line. The adult discreetly arranges the pictures in a logical order during this brainstorming process. At the end of the exercise, the student “reads” the assignment to the adult, using the pictures (or keywords) as prompts. This verbal rehearsal helps the student hear the logical flow of the language. The student then completes the writing assignment using the timeline as a visual support.

Concern #3: Motor Control and Planning. “He can’t get started. When I ask him to write, he just sits there.”

Think about inertia, which is defined as resistance or disinclination to motion, action, or change. Inertia appears to be a function of the neurological processes (Reed and McCarthy 2012) that control a person’s ability to shift attention and plan voluntary motor movements (Minshew et al. 1997). According to Larson and colleagues (2008), when a person has difficulty with shifting attention and motor planning, the result is often a tendency to stay still (i.e., remain in a state of inertia). Inertia describes the difficulty many individuals with ASD have with getting started on writing assignments.

For younger students, provide hand-over-hand support for the first written word of the assignment. With each letter of the word, keep your hand in place, but slowly fade the pressure of your hand on the student’s hand. When you feel that the student has begun to write, slowly fade the presence of your hand. Often this minimal physical prompt will be enough to break the cycle of inertia and allow the student to proceed with the assignment on his own.

For older students, break the cycle of inertia by lightly tapping the paper at the spot where the student is to start writing. Often this silent, noninvasive cue will be enough to help the student initiate movement. The tendency to revert to a state of inertia is strong with students on the spectrum, so the adult will need to be prepared to repeat the silent cue whenever the student appears to be stuck.

Concern #4: Sensory Regulation. “Every time he’s asked to write something, he has a meltdown!”

The vestibular system controls many of the skills required for writing: equilibrium, balance, the ability to hold the head and neck upright against gravity, bilateral control between the two sides of the body, and eye/hand coordination. When individuals with ASD are required to regulate these sensorimotor challenges, manage the language and organization challenges needed for writing tasks, and at the same time filter out the bombardment of sights, sounds, smells, and movements that surround him, the result is often refusal or meltdown.

Provide a movement break before starting a writing assignment. Have the student do 30 wall push-ups before sitting down to write. Or, before starting a homework assignment, ask the individual to carry a full laundry basket up and down the stairs a few times. Intersperse fun movement breaks into the writing task (e.g., write five sentences, do five minutes of brisk game activity with a Wii, followed by five more sentences). Not only do these movement breaks provide positive reinforcement for work completion, they also stimulate the vestibular system and help regulate sensory integration needed for writing.

Writing is hard work for students with ASD. Even simple writing tasks require skills in language, organization, motor control and planning, and sensory regulation. Difficulty in these four areas can lead to refusal or meltdown when the student is asked to write. Consider which of the four areas might be affecting your student’s ability to write, and intervene with this in mind. With appropriate supports at home and at school, students with ASD can become happy, successful writers!

Kathy Oehler, along with Cheryl Boucher, is coauthor of I Hate to Write! Tips for Helping Children with Autism Spectrum and Related Disorders Become Successful Writers (AAPC, 2013). Learn more at http://ihatetowrite.com.

References

Just, M. A., V. L. Cherkassky, T. A. Kellar, and N. J. Minshew. “Cortical Activation and Synchronization during Sentence Comprehension in High-functioning Autism: Evidence of Under-connectivity.” Brain, A Journal of Neurology 127 (Pt 8; June 23, 2004): 1811–21. http://www.ncbi.nlm.nih.gov/pubmed/15215213

Larson, J., A. Bastian, O. Donchin, R. Shadmehr, and S. Mostofsky. “Acquisition of Internal Models of Motor Tasks in Children with Autism.” Brain: A Journal of Neurology 131 no. 11 (2008): 2894–2903. doi:10.1093/brain/awn226

Minshew, N., G. Goldstein, and D. Siegel. “Neuropsychological Functioning in Autism: Profile of a Complex Information Processing Disorder.” Journal of the International Neuropsychological Society 3 no. 4 (July 1997): 303–316.

Mostofsky, S., S. Powell, D. Simmonds, M. Goldberg, B. Caffo, and J. Pekar. “Decreased Connectivity and Cerebellar Activity in Autism during Motor Task Performance.” Brain, A Journal of Neurology 132 no. 9 (2009): 2413–2425. doi:10.1093/brain/awp088

Reed, P., and J. McCarthy. “Cross Modal Attention Switching Is Impaired in Autism Spectrum Disorders.” Journal of Autism and Developmental Disorders 42 no. 6 (June 2012): 947–53.

Copyright © Autism Asperger’s Digest. 2013. All Rights Reserved. Distribution via print is prohibited without written permission of publisher.

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Dear Friend,

The Autism Asperger’s Digest, a division of Future Horizons, Inc. was created to meet the needs of teachers, therapists, and family members who face the challenge of autism. Our books, videos, and conferences are geared to bring you the most current information possible to assist in that challenge.

It is our strong belief that every child and adult with autism can improve and contribute to the lives of those who love them and, in many ways, contribute to society.

We at Future Horizons pride ourselves in bringing to the mission not only a strong sense of professionalism, but one that is also based on personal relationships. Virtually all of us have family members or friends who are affected.

Personally I am proud to be the father of a wonderful son, whom I had the immense pleasure of watching develop into a fine young man. Alex was a light that lit up lives wherever he went.

Whether working with TEACCH in North Carolina, speaking at Future Horizons conferences, attending the family gatherings he enjoyed so much, meeting people at our bookstores, working in the jobs he held, etc., his delightful sense of humor, courtesy, and caring improved the lives of all who knew him. You could not help but smile back at his infectious grin.

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Alex made me a better man and is the genesis for this company. People often compliment me or my staff as they relate how our offerings have made their lives easier and better. With due deference to the fact that I have a terrific staff, we and you owe it all to him. Without him, Future Horizons would not exist.

His memory lives on through our efforts. Thank you, Alex. I’m honored that you called me Dad.

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About Future Horizons
Future Horizons was founded in 1996 in the belief that dissemination of information about autism and Asperger’s Syndrome through books, conferences, and other media would beneficially impact those who live and work with the condition, personally and professionally. Devoted entirely to supporting and fostering such works and programs, Future Horizons has grown to be a world leader in publications and conferences on autism and Asperger’s Syndrome.

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Why Johnny Can’t Be Good

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Why Johnny Can’t Be Good
By Ellen Notbohm
Autism Asperger’s Digest September/October 2013

Holiday traditions and activities can create bafflement for concrete-thinking children with autism; in our family, none more so than hype-y, happy Valentine’s Day. Paper hearts and candy in every conceivable form blare the ubiquitous romantic request—or is it a demand?—Be my Valentine, or its more succinct version, Be mine. How, Bryce pondered one year when faced with the usual classroom party, was he supposed to do that? What do you have to do to be a Valentine? What if he didn’t want to be a Valentine? And Be mine, well, that was downright scary. How could he be someone else’s? Did he have any choice in the matter or was Be mine an order, a have-to?

Shakespeare’s Hamlet famously chewed over the question, “To be, or not to be?” Paul McCartney’s last musical advice before leaving The Beatles was “Let it be.” Contemporary pop music is replete with song titles like “I Will Be,” “Has to Be,” “Meant to Be,” “Just Be,” “May It Be.”

“I know he can’t be good all the time,” the exhausted mom of an eight-year-old with autism told me, with tears in her eyes. “But why can’t he do it for just a day? A morning? An hour?” As we talked, many reasons emerged. But the starting point was this: how is a concrete-thinking child to infer what we mean by “good” when it may be the most subjective word in the English language? It’s an adjective, a noun, an interjection, an adverb. Dictionary.com cites sixty-four—sixty-four!—definitions and sub-definitions. “Good” is a moving target that changes from venue to venue, relationship to relationship. It changes with the time of day and it changes as the child ages. Defining “good” so that our kids can practice and master “being good” in every increment of every situation is an intensive process that, alas, too many adults trust to osmosis, to inferential skills our kids haven’t been taught, to inductive reasoning patterns not present in the thinking architecture of autism.

Even when we define “good,” we often couch it in negative terms. The weary mother’s definition of being good translated into don’t hit your brother, don’t throw things, don’t yell. We might think her list short and reasonable, but any demand that requires the child learn and master more than one thing at a time is a list too long. Small, incremental successes will naturally build upon one another, but multiple simultaneous expectations all but guarantee failure. Consider further: in order to be good, a child must feel good. In defining the “good” we want from them, do we acknowledge and validate the emotions, motivations and triggers behind a child’s behavior? Do we teach her the self-regulation strategies to deal with them, providing time and opportunity for her to practice those skills in a supportive, nonjudgmental way? Telling a child what not to do (don’t hit your brother) doesn’t tell her what to do. Even when phrased in active terms—how often have we said “keep your hands to yourself” or “button your lip,” idiomatic phrases that confuse the concrete-thinking child with autism—it doesn’t address the anger, frustration or fear behind the child’s thumping her brother. Learning to “be good” doesn’t mean she never gets to be angry, exuberant, frustrated or super-energetic. It means teaching her acceptable outlets for all her normal human feelings.

We would never tell a child to be a doctor, be a concert pianist, be a welder or a golfer or a reader without the understanding that a long period of explicit instruction and practice (which by definition includes making mistakes) precede the becoming of those things. When the U.S. Army adopted the slogan “Be all you can be” in 1980, the implication was that the Army would train the recruit to be all that he or she could be, not that the recruit would achieve it upon enlistment. When “be” is the embodiment of attributes as abstract and culture-defined as goodness, courtesy, courage or patience, it’s our job to break down these traits, shape their relevance to the child with autism and teach in concrete terms how to achieve the goals we set. We must define not only the actions necessary but also the steps in social thinking that underlie the actions (see “Being Social Begins with Thinking Social”). And we must hold ourselves accountable for the examples we set.

Our exhausted mother at the beginning of this piece felt better when we broke down her “why can’t he be good?” into actionable increments: Set one goal at a time, prioritized starting with behavior that is dangerous and requires immediate attention, descending to behavior that is annoying but of no real consequence. Begin with, and reward, success in small increments of time (a half hour, not a whole morning), gradually increasing. Provide visual prompts for reference, reminder, warning. Create Social Stories(TM) for specific behaviors. Don’t hold him to a different standard of behavior than his siblings.

The same approach applies to the classroom. This true tale, an excerpt from Ten Things Every Child with Autism Wishes You Knew, skewers home the point:

I’ll never forget a story I heard years ago about a whirling dervish of a girl with ADHD, nine years old. Her teacher proposed a deal, a reward for meeting a behavioral goal. If the girl could “be good” for three weeks, the teacher would buy her an ice cream cone. The girl reported to her therapist: “Is she kidding? I can’t ‘be good’ for three hours, let alone three weeks. And besides, I don’t like ice cream.”

The goal: unrealistic, out of reach.

Guidance offered to help in accomplishing the goal: none.

The reward: irrelevant, and nowhere near equal in value to the effort required.

Here’s a scenario more constructive times six: Teacher and student (1) meet one-on-one and (2) discuss and agree to (3) a specific, (4) short-range goal (5) that is achievable and (6) has a meaningful motivator as a reward. For instance, the student will work toward remaining in her seat or other designated spot during silent reading time, which is the twenty minutes following lunch recess (short period of time following a physical-release outlet offers best chance of success). She’ll start with five-minute increments and work up from there. Success will earn her a token toward computer time, a movie pass or other mutually-agreed-upon end result attractive to her.

Why can’t he be good? He can, but not until we take a dose of our own medicine: be patient. As is so often the case, our answers might be found in the mirror. George Gershwin gave us the turn-the-tables perspective in his famous song lyric: “I am so awf’ly misunderstood. So lady, be good to me.”

BIO
Ellen Notbohm is the author of one of the autism community’s most beloved books, Ten Things Every Child with Autism Wishes You Knew, and three other award-winning books on autism. Visit her at www.ellennotbohm.com and find her on Facebook at https://www.facebook.com/ellennotbohm. Please contact the author for permission to use in any way, including posting on the Internet.

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Fiona Thornely says:

October 31, 2013 at 12:11 am

I am learning so much from you about how to understand and help my son, Tommy, with ASD and ADHD.

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December 27, 2016Blog, Behavior, Featured Articles, Newly Diagnosed, Temple GrandinTemple GrandinAutism Asperger’s Digest

by Temple Grandin, PhD
Autism Asperger’s Digest | November/December 2011

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Whole Task Teaching for Individuals with Severe Autism

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Autism: The Way I See It; Whole Task Teaching for Individuals with Severe Autis
by Temple Grandin
Autism Asperger’s Digest | September/October 2007

The standard method for teaching a nonverbal person with autism tasks such as dressing or cooking is to provide a picture schedule that shows the steps of the task. This works well for many individuals, but some have difficulty linking the steps together. To learn a simple task such as making a sandwich, they have to see a person demonstrate the ENTIRE task, from start to finish, with no steps left out. If they do not see how the second slice of bread gets on top of the peanut butter they may not try to perform the individual steps because, as a whole, they do not make sense to the individual.Sandwichmaking is easy to teach because when the task is demonstrated the ENTIRE task is observed, and the end product – the sandwich – is concrete and has meaning to the individual.

This idea of “whole task teaching” is particularly relevant in the area of toilet training. One of the challenges with toilet training individuals on the severe end of the spectrum is that the individual may not know how the urine or feces gets into the toilet. The picture schedule shows the waste in the toilet, but it does not show how it got there. There are often more problems with teaching the person to defecate in the toilet compared to urination. This is because the individual has more likely been able to directly observe how urine comes out of the person and goes into the toilet. This is especially true with boys, but even girls can observe this. It is not as obvious an action – for either sex – when it comes to defecating. If seeing how the waste goes from the person to the toilet is left out of the teaching sequence, these individuals may not know what they have to do.

Furthermore, neurotypicals assume a picture is all that’s needed to help the child or adult link the elimination of bodily waste to the place where it should go, i.e. the toilet. But for many individuals that link is too broad a jump and does not “compute” in their brain. Those with severe sensory issues may not feel the sensation of having to urinate or understand how to bear down to defecate. These are intermittent steps that may need to be addressed for a successful toileting program.

Sometimes even demonstrating a whole task via visual teaching is not enough. Many individuals on the severe end of the spectrum have so many visual processing problems that they have to learn tasks by touch. One therapist taught a child how to use a playground slide by “walking” him through the entire task hand over hand with no steps left out. To understand how to climb the ladder and go down the slide the therapist stood behind the child and moved his hands and feet through the entire sequence: climbing the ladder, sitting on the slide and going down it.

Teaching how a foot is put into a shoe can be done in a similar manner. The therapist, hand over hand, guides the individual’s hand over the ankle and foot so the person can feel the foot, then feel the inside of the shoe so they can cognitively link how the foot could slide into the shoe. The next step, hand over hand, is to slip the foot into the shoe in one continuous motion, so the individual experiences the feeling of the foot going into the shoe and makes the cognitive connection through the tactile information being received.

Individuals on the more severe end of the autism spectrum can be taught to perform different actions, but we must not lose sight of the accompanying sensory issues that can impede their learning. In many cases, these sensory issues are severe and rob the individual of much of the “data feedback” necessary for learning that neurotypicals receive unconsciously. Whole task, visual and tactile-based teaching strategies can supply the extra information these individuals need in order to learn.

BIO
Temple Grandin is an internationally respected specialist in designing livestock handling systems. She is the most noted high-functioning person with autism in the world today.

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When Things Don’t Go My Way

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by Katie Brady, LCSW
Autism Asperger’s Digest | September/October 2012

We are all creatures of habit, but individuals with autism spectrum disorder (ASD) are even more inclined to create routines and rituals in order to make sense of the world. At times these routines can be functional and essential to living. For instance, we all probably have a routine of brushing our teeth; we generally re-create this sequence of steps twice a day, without giving much thought to our actions because the routine is entrenched in our brains. But often, in the absence of information or clarity, nonfunctional routines or expectations are created that can cause problems when things don’t go the way the individual with ASD expected.
Chances are that you can name some routines that your child or student with ASD exhibits. These could be having to line up Mario toys in order based on the sequence of appearance in the video game, insisting on driving to school a certain way, only brushing teeth with mom, turning on all the lights in the house before dinner, or going outside every evening to say goodnight to the stars and the moon. Most of these routines seem pretty benign—until a certain Mario toy is missing, or there is construction along the school route! Then, things have certainly not gone
the right way, and a meltdown may
be inevitable.
It’s important to understand that individuals with ASD create their own expectations and routines at many times, especially when they are not given enough information or when a routine has already been established (on purpose, or accidentally). To help individuals with ASD understand what the actual expectations are, and to prevent behavioral outbursts when a child thinks things have not gone his way, we as therapists, educators, and parents can help promote flexibility, prepare for differences, and pick battles wisely.

Promoting Flexibility
It is critical that we, as parents and educators, understand the value of teaching flexibility. Too many times I have heard someone ask, “Since my child likes routine, should we do the same activities in the same order every day?” I always emphatically respond with “No” and then explain how the idea of maintaining the same routine day in and day out is not only impractical, but it does not teach the child flexibility and instead sets the child up for failure when the routine changes.
Instead, the child should be taught a more functional routine of looking to a visual schedule or story to get information about what he is going to do. Maybe the child always comes home from school, puts his backpack away, takes his shoes off, and has a snack (functional routine). Then the child looks at his afternoon schedule and sees that he will have some homework time, a chore or two, and some leisure time. However, the order, length, and type of activities may vary each day.
We must keep in mind how to promote flexibility within specific activities as well. Using visual lists and schedules, we can let kids know what to expect. For instance, a list might tell the child that one day he will walk three laps around the lake—another day, five laps. And parents might have a rotating list that lets family members take turns deciding which route they want to drive to school.

Preparing for Differences
Equally important to promoting flexibility is preparing for differences, which means we have to be able to predict when differences might occur. We have to be especially practiced at thinking ahead about potential differences that will bother spectrum kids.
Luckily, it is easy for us to predict and prepare for some differences. For instance, when taking your child to the state fair for the first time, you can predict that it will be noisy, crowded, and overstimulating. You have a sense of what foods, games, and rides your child will enjoy, and what he will dislike. You can prepare by choosing the least busy time, creating a story or schedule to prepare your child, and bringing essentials (like noise-cancelling headphones or a preferred snack) should things head south quickly. If you know your child will want a stuffed Sponge Bob, you can choose to spend as much money as it takes to win that prize, or avoid the arcade area at all costs!

Picking Battles Wisely
Finally, we must remember to pick our battles wisely, and not engage in power struggles just for the sake of “proving a point” or “showing who’s boss.” I recently observed a classroom where a child chose a puzzle for her free time. She then wanted to get out another puzzle, but the teacher reminded her that the rule is one puzzle at a time. The child asked for “Letters and Numbers? Two puzzles?” but the teacher repeated the one-puzzle-at-a-time rule. Then, the child began crying and was upset for about 30 minutes, asking for both “letters and numbers!” In the end, she didn’t complete either of the puzzles.
One possible solution is to clarify the teacher’s expectation to the child. The child chose the puzzle icon and went to the puzzle area, so she clearly understood that it was “puzzle time.” However, she did not understand the rule about one puzzle at a time. This expectation needs to be clarified visually to the child, either through a checkout system or by letting the child know visually (using a first-then sequence) that she can complete the letter puzzle first, and then the number puzzle.
Another solution, though, is just to let the child have two puzzles. What is the point of limiting the number of puzzles? It turns out that for this classroom, the teacher wanted to limit the number of puzzles because it was easier to clean up, which does make sense. However in this situation, the expectations were not communicated to the child in a way she could understand, so the child created her own expectation. This led to her becoming upset and disengaged when things did not go her way. I would argue since the teacher could not communicate to the child effectively, she should meet the child halfway and let the child do two puzzles this time, then work on a visual system to clarify expectations for the future.

There are always going to be times when things don’t go the way spectrum kids expect them to go! Change is hard for kids with ASD. Now you have a better sense of strategies to use that will help your spectrum kid deal with change and unmet expectations. Often a preventive strike will defuse a real battle!

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Sharon Lawson says:

August 30, 2012 at 1:20 am

Great article Katie. Practical advice for all parents.

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