TEACHING THE CHILD TO PLAY
When I tell parents that the first thing we want to do is teach their child to ask for things they want, I frequently hear, "But he doesn't want anything!". All children want something and there are things we can do to increase both the variety and number of things they want. (Increase potential reinforcers) I feel it is imperative that we "teach" the child to enjoy many things so that we can increase the opportunities for teaching as well as give them activities to participate in that are more fun (reinforcing) than "stimming".
The Importance of Play
The importance of teaching a child to enjoy "play" cannot be over emphasized. While it is certainly possible to teach a child to point to pictures, imitate actions and imitate words in artificial or contrived situations, it is less likely that the child will use these skills in a functional manner unless we teach him using the types of things that he is likely to encounter in the "real world" (generalization). In addition, if these "real world" items (toys, games, people) are not reinforcing to the child, we will only have an "EO" (establishing operation) for the child to talk when he's in this artificial environment (sitting at a table) with artificial stimuli (pictures) and artificial reinforcers (videos, candy, treats). Therefore, an ongoing "goal" in any program should be to pair established reinforcers (foods, touches, smells etc.) with new items to create more and more things the child enjoys (conditioned reinforcers).
To help determine the types of toys or activities a child might enjoy, we can look at the types of self-stimulating behaviors he engages in and investigate the way he reacts to a variety of sights, sounds, tastes and movements in the environment (stimuli). The attached questions will help guide you as you learn about each unique child. You may not know the answers to some of the questions at this time. To answer the questions, try presenting various sights, sounds, touches and tastes and see how the child reacts. Once the questions are answered, use the information to help you determine the best types of toys or activities to introduce to the child. Some suggestions are provided based on the information you gather.
The most important thing to remember is that any time you introduce a new toy or activity; you want to "pair" it with "reinforcement". In other words, doing something the child might not enjoy a great deal in combination with something you know he does enjoy. This same idea holds true no matter what new activity you're introducing. Any reinforcer can be used to "pair". For example, if the child enjoys being held tightly, pair this activity with reading a book. If he likes to watch things spin, choose toys or activities that have spinning parts. If he likes silly voices, use them while playing with him. If he likes music, sing or exaggerate the inflection on your voice while interacting with him.
After we have the child "hooked" or enjoying the activity (pairing occurs), we can teach him to ask for the activity or perhaps ask for various pieces or parts within the activity. If the child is non-verbal, you can teach them to ask for the activity using signs or pictures. You can also being to pause before the last word to see if the child will "fill-in" the last word. This is partly an intraverbal response but also partly a mand if the child is responding so the activity will continue.
Many of the first toys and activities chosen to introduce to the child may be considered "stimmy" toys. For example, tops, spinning wheels, gears, or ribbon sticks. In other words, if left alone with the toy, the child may choose to watch it or interact with it over and over in a repetitive way. It is important not to let the child "play" with the toy in this fashion because, as we've discussed previously, self-stimulating behaviors tend to reinforce themselves. We don't want to increase the child's self-stimulating behaviors by allowing them unlimited access to these toys. What we are trying to do is pair the reinforcer (stimmy toy) with talking and interacting with you. These are toys that should be kept up and away in a special place to only be played with when engaged with an adult. It is important that the instructor maintain control over the toy or parts of the toy to keep the child from "stimming" and ignoring the instructor! If you find one toy or activity the child is interested in, try to find others that may offer the same or similar sensory stimulation to the child or use it to pair even more varied toys and activities.
Another set of toys or activities to look closely at are those which combine some "cause and effect" with pretend play. For example, a car wash that really squirts water, stoves that make bubbles when you cook or toy sinks that squirt out real water when they're pushed. If the child enjoys the "cause and effect" part of the toy, you can often get the child to respond to you by controlling that part of the toy yourself. For example, if the child wanted to see the bubbles from the stove, he's more likely to request, "cook" if you're holding onto the burner knob!
One of the biggest mistakes I see people make is to sit down with the child to "play" and start asking a bunch of questions. This isn't play, it's testing, and the child may find it aversive. Instead, it's typically best to avoid placing demands on the child and just enjoy the toy with him/her. (non-contingent reinforcement) For example, many children enjoy "silly" voices and exaggerated intonation patterns, especially children who also prefer music. If this is the case, you might sing or say the same series of words as you play with the toy with a "melodic" tone to your voice. For example, if you were bouncing the child on a therapy ball, you could say, "bouncy ball, bouncy ball, all fall down". Roll the child off the ball as you say "down". If this is done repeatedly and the child is enjoying the activity, it is likely that you will begin to notice him looking at you expectantly when you get close to saying "down". Begin pausing before saying down and you may find the child filling-in the word "down" for you! This fill-in then becomes a behavior we can reinforce, shape and transfer to other functions of language (verbal operants).
Try to avoid simply narrating what you see the child doing and instead participate in it. For example, if the child is rolling a train on a track, get another train and pretend to crash into his train or chase his train around the track. If he appears to be repeating the same activity over and over, interrupt him in a playful manner. For example, if the child is running in circles around the room, swoop him up into the air and "fly" him around the room instead.
Some children just need to be around a new toy for a while before they will begin interacting with it. If the child has this type of history, just leave the toy in the room for a few days untouched. Gradually begin playing with the toy yourself, when the child is in the room but a distance away. Let the child see you put the toy in a location where it's visible but not accessible. Wait until the child comes to you while you're playing with the toy rather than going to him with it. Just because a child runs from a toy the first time it's presented doesn't mean that he won't enjoy it later.
Be aware that some children get very "stuck" in having to play with a toy or hear a story in the exact same way every time. Because of this tendency, a toy that the child appeared to love while playing with mommy isn't the least interesting when playing with daddy! If this appears to be happening with a child, carefully watch the person he seems to be enjoying the toy or activity with to help determine what the child is finds pleasurable in the activity. Perhaps it's a silly voice or the way a specific word is said. While we don't necessarily want to encourage this apparent need for "sameness", we can use the information to determine how we might make the same toy just as fun (potential reinforcer) for the child but in a different manner.
Be aware that some children become increasingly excited when interacting with some toys, especially "stimmy" toys. If the child appears to become very active and seems to be unable to focus on what you're doing, take a break and do a different type of activity that involves different stimuli. For example, if a child begins jumping up and down and clapping while playing with a top you might ask him to sit then take a break and engage in an activity with a history of calming the child. You have to be careful not to unintentionally reinforce any negative behaviors by reacting to the child's behavior. Use the information but wait to switch to another activity when the child is exhibiting a desirable behavior if the new activity may be preferred over the current one.
The following teaching techniques have been found to increase the child's interest in people and/or toys. Remember the goal at this point is that the child "allows you" to enter his play and you become part of the reinforcement he is getting from the situation.
1. Build anticipation- Repeat the same words or sequence of movements over and over in the same manner then pause.
Ex: Play "Peek -a- Boo". Say, "ahhhhhh Boo!" as you gradually move toward the child and take a blanket off your head. As the child begins to attend to you, you will notice a smile and eye contact as you get closer. The child may begin to laugh as you remove the blanket. When you begin to see this happening, stop, right before you say, "Boo!". The child may fill-in "Boo" or try to take the blanket off your head for you!
2. Do something unexpected- Repeat an activity in the same manner then all of a sudden change the routine.
Ex: If the child is eating a cookie, say, "I'm hungry" and move toward the cookie taking a few pretend nibbles. After he has tolerated this a few times, move toward him and make loud, sloppy eating sounds!
3. Imitate what the child is doing then make a game of it.
Ex: The child is stomping on pinecones while you go for a walk. You take a turn stomping on the pinecones saying, "I found one! Stomp". Then tell him, "Your turn. Stomp" as he stomps on the pinecone. As this "game" progresses, perhaps you could find more pinecones and put them in a circle or another pattern to play the "stomp" game. Notice the author is not suggesting imitating stims but turning them into meaningful play.
4. Interrupt the child's "play" by playfully obstructing-
Ex: The child is repeatedly going up and down an indoor slide, crashing into pillows at the bottom. Grab his leg (gently) at the top of the slide and "wiggle" him saying, "Oh, No! I caught you!" You will know whether or not the child finds this "fun" if he's smiling. Wait for the eye contact before saying, "Let go?" in a questioning manner then letting the child go down the slide. Or, if a child is running around in circles then crashing into the couch cushions, place some pillows on the floor and crash into them instead. Make sure you take turns crashing!
5. Pair words/sounds with what the child is doing-
Ex: As the child is drawing by himself, say "draw, draw, draw" or "around, around, around and stop", or "up and down, up and down." (Whatever describes what the child is doing.) Use the type of voice (i.e. sing-song, quiet, exaggerated) the child typically enjoys. Just the pairing of these words or sounds with reinforcement make it more likely that the child will use the words/sounds later. (automatic reinforcement)
6. Do something unexpected-
Ex: If the child is repeatedly scooping shovels full of sand or rice and watching it flow into a pail, pretend to eat it! Or bring a favorite character (i.e. Elmo? Barney?) over to the play to "eat".
7. Use exaggerated facial expressions/body movements to make yourself "stand out"-
EX: Open your eyes wide, fall down with a big "boom!", cry with your mouth wide open and your hands rubbing your "tears".
8. Create meaning- Even if you don't think your child said a "real word", listen to the sounds he's making and act is if they have meaning.
Ex: While drawing, the child is babbling and says something that sounds like "sun". Quickly pick up a marker and draw a sun as if the child asked you to draw it. (A history of reinforcement creates "meaning".)
9. Introduce other "characters" into the play.
Ex: The child enjoys having you bounce him on a ball. Bring in other toys and let them bounce on the ball. If the child starts pushing these characters off the ball say, "Go away, Elmo" as the child pushes the characters away.