Story
Most infants and children follow a natural trajectory of development. Milestones have been identified as a child acquires skills along this path. It is a trajectory that leads to learning readiness and successful school outcomes. It includes the social competence needed to navigate uncertain and unpredictable exchanges with peers and community members. It is a shared set of customs that are agreed upon as acceptable within a culture. Encompassing an essential skill set, it makes lifelong independence and survival possible.
A person with autism may not be inclined to follow this same trajectory. The strength and variety of autistic features unique to that person may result in a developmental path that veers in a different and unique direction from the start. As development continues the path may become increasingly different and in some cases limiting.
Perhaps the most helpful intervention strategy would be to identify missing and delayed milestones and attempt to replicate the natural learning experiences that might lead to acquisition. Autism friendly lessons and activities could be tailored to accommodate a person's unique learning style and sensory needs. The following are my observations and ideas for possible interventions. They are offered here for discussion only and not as recommendations for treatment.
Framework: Executive Function
Executive function is the way in which we marshal our thoughts and actions in order to accomplish tasks and complete long range goals. It requires planning, organization, flexibility, and monitoring. A person must identify the steps that will be taken and then recall these steps in the order that they will be completed. If different activities are required we must shift our thinking and actions accordingly and then monitor our activities so that we remain focused on the task at hand.
Planning, Organization, Flexibility, and Monitoring:
- In order to be productive we must choose long-term goals and then carefully analyze each to determine the tasks that are required. We must identify the order in which these tasks will need to be completed as well. The necessary skills and materials for each task must be considered. If others are involved we must plan how to solicit their cooperation. Time, resources, and location must be available.
- Once planning is complete we must begin by remembering the steps we identified and the order in which they must be done. We must also recall what materials must be located and who will be involved.
- As each task is completed we must shift our thinking to the next task. If we pause to do other things we must be able to come back to where we left off and pick up the work again. With especially large projects that must be completed over a long span of time we must be able to keep track of progress and work steadily until completion, making revisions when needed.
- When work is begun on a task, focus must be maintained on the activity. Distractions must be ignored. Attempts at multitasking may derail progress.
Strategies for Activities, Lessons, and Materials:
- Children can have frequent opportunity to independently complete tasks that have several steps. They can be asked to recall the steps when finished.
- Children can be given a daily routine of hygiene and housekeeping tasks to complete independently.
- Children can be given the opportunity to sequence pictured steps in basic hygiene, housekeeping, and cooking activities.
- Children can be given the opportunity to follow a recipe with 5 or more steps. They can then be asked to recall how the food was prepared. They can keep a collection of favorites and prepare them often.
- Children can be given the opportunity to pack a lunch for school. They can plan a week of lunches, shop for ingredients, and then prepare the planned lunch each day.
- Children can be given the opportunity to pack for a short trip away from home. They can be given a short itinerary and be asked to pack what will be needed.
- Children can be given opportunity to follow written directions (with and without images) to complete a task with 5 or more steps. They can be asked to recall the steps when finished (with and without the directions).
- Children can be asked to determine the sequence of steps in a short video of a task either orally, with text, or with individual images.
- Children can be asked to plan a short academic project identifying steps, materials, and time frame.
- Children can be asked to plan an extended school project that involves several sequenced tasks. They can determine the steps and materials for each task. A full project schedule or time line should be included. The child should describe the process when the project is complete and discuss any revisions that were needed.
- Children can be given graphic organizers that are designed for project planning. They can be encouraged to use digital calendars and planners to record the project steps and then check off each when completed.
- Children can be given the opportunity to play with construction toy sets that require directions to be followed.
- Children can be given the opportunity to assemble purchased items that require following written directions and tools.
- Children can be given the opportunity to use printed and digital planners for daily and long term assignments.
- Young adults can be asked to complete mock weekly, monthly, and annual budgets for specific incomes and plan for food, clothing, devices, housing, transportation, and entertainment.
A person with autism or other developmental delay might:
- be easily distracted and struggle to recall the steps to complete daily hygiene and housekeeping tasks.
- dwell on the details of a task and be unable to complete it in the required amount of time.
- have difficulty stopping a preferred activity in order to begin an assigned task.
- confuse the order in which a routine task must be completed.
- struggle to place images of steps in a basic task in sequence.
- be easily distracted and leave a task unfinished.
- misplace or have difficulty finding needed materials.
- put off beginning steps in a task and then struggle to complete it on time.
- have difficulty understanding or remembering oral directions.
- struggle with tasks due to delayed fine motor skills.
- not enjoy toys that require assembly if fine motor skills are delayed.
- have difficulty understanding written directions without images.
- write things in a planner and then be unable to read them.
- struggle to complete long-term projects that require completion of multiple tasks in an extended time frame.
- struggle to complete steps in a task in the allotted time frame.
- stop a task or project completely if one step proves to be too difficult.
- struggle to complete projects that do not contain images and do not involve construction of real objects.
- struggle to complete projects that require a lot of reading of complex text.
- struggle to complete projects that require a lot of writing of multiple paragraphs and use of complex language.
- struggle to plan an assigned project with a group of peers or complete an assigned task in the group project.
- may complete an assignment in the allotted time frame but forget to turn it in to the instructor.
- be unable to understand text that accompanies diagrams when using printed directions to assemble an item.
- be discouraged by or unable to use tools or materials that require fine motor strength and coordination.
- be preoccupied with sensory sensitivities.
- lack assumed skill levels in related areas.
User Friendly Strategies for Activities, Lessons, and Materials:
- Take photos as a child completes the steps in simple tasks. Use the photos to order in a sequence and recall the task. The images can be used to prompt the task at a later date.
- Post sequenced images of daily hygiene and housekeeping tasks in the location in which they will be attempted to prompt independent completion.
- Prompt a child to return to a task and allow extra time for completion.
- Choose tasks that do not exceed a child's language comprehension and motor skills.
- Simplify complex text in task directions.
- Simplify and reduce complex writing requirements in a task.
- Arrange to have peers in group projects that can be accommodating when a child has difficulty.
- Include submission of a final project as a step in the process.
- Before beginning a project practice use of needed tools or materials that require fine motor strength and coordination.
- Observe and detect sensory sensitivities to materials and environment and alter as necessary.
- Observe carefully to detect competencies in order to know what they don't know.
