Educating preschool children with autism: A parent's perspective

Iam the mother of a beautiful, healthy, robust, rewarding, and loving six-year-old boy whose favourite activities are hockey, skiing, boating, Yu-Gi-Oh! and X Box. Together, these qualities and interests, along with many others, make up who he is as an individual. It is Eric's autism however, and the recommended treatment of intensive early intervention, that has impacted his life and our lives so very much since his diagnosis at three years of age. Note that ‘intensive intervention’ means education, education and more education in, most often, a very strict and deliberate way. This brings me to why I am writing this article. I was asked by Dr Susan Bryson, Autism Chair, Dalhousie University (Halifax, Nova Scotia), to write an article about educating preschool children with autism from a parent's perspective. It is widely known by most parents and professionals that the recommended treatment for autism is a minimum 20 h to 40 h per week of intensive intervention (structured learning, applied behavioural analysis [ABA], intensive behavioural intervention [IBI]). As expected, Eric has benefited tremendously from this therapy – it is well documented that ABA/IBI therapy has proven results. I had no idea that Eric would progress from being a nearly nonverbal child with many behavioural problems to the nearly fluent, generally cooperative, social, athletic boy that he has become. The success of this type of therapy is already well documented and widely publicized. However, as a parent, I know for a fact that Eric's progress is not due to ABA/IBI therapy alone. Therefore, it is these other elements of success that I would like to share with you in this article. First, a little history about Eric. Eric was diagnosed with autism at the age of three. The medical profession told us that Eric needed intensive early intervention. We had no idea what that looked like, who to go to for help, or how to deliver it. Very anxious about the ‘early’ in ‘early intervention’, we hastily slapped together a home program that, not surprisingly, delivered mediocre results. We got better with time and experience, but were very relieved when Eric was accepted into a specialized program for children with autism at Mount Saint Vincent University (Halifax, Nova Scotia). The results of this program, combined with his ongoing home program and other factors, were phenomenal. I believe that the medical community could offer better advice to parents than simply recommending 20 h to 40 h of intensive intervention. That is a crucial piece of advice (and a daunting task for parents) but the message is consistently delivered without giving families HOPE. Doctors must understand and confidently communicate to parents that all children, regardless of level, have real potential to learn, develop and improve. When Eric was three, one doctor stated to us that autism looks at its worst at three and that things would get significantly better over the next few years. I hung on to those words – the only hopeful words spoken to us by any professional. Guess what, HE WAS RIGHT!!! I understand that doctors cannot predict outcome. However, they can assure parents that things will improve and that parents themselves can facilitate learning by incorporating strategies into their daily routine and by advocating for their child. The following are some of those strategies that have worked for us. When teaching your child any skill, always provide visual tools or cues. For example, if you want to teach your child to set the table, provide placemats that are templates. If you want your child to put his clean laundry away, then label his drawers with picture symbols. The same goes for flushing the toilet, washing hands, etc. Your child's world is full of fear and anxiety that is hard for us to understand. I do know that Eric learns and behaves best when he feels calm and secure. That means that if a night light and blankie make Eric feel secure, then he gets them. If we are going to the mall and he wants to bring a stuffed animal, we bring one. We never take away anything that provides Eric with comfort or security. His security is more important than conforming to the norm. Eric needs to finish what he is doing before he is capable of transitioning to another activity. It's worth the wait, ie, you can wait patiently for a few minutes or endure a tantrum that lasts many minutes and leaves you both frazzled. Set realistic goals for your child and meet them! For example, I was determined that Eric develop joint attention. We shopped together (he in his pajamas when he wouldn't wear clothes), walked together, cleaned together, did everything together all the while with me holding objects in front of him saying, “Look, look at the ______”. Finally one day Eric pointed to my earring and said, “Look, earring”. This was a major turning point! We achieved our goal because we were focused and determined. Use your local school board's Individual Program Plan/Individual Education Plan format for your own planning, goal setting and evaluation. This will make your transition to elementary school easier and provide a starting point for developing your first Individual Program Plan/Individual Education Plan within the public school system. Introduce your child to sports at a young age and persevere. I remember teaching Eric to skate when he was three. It took 15 trips to the arena before he would allow me to put his skates on and even then I had to carry him around the rink. Eric is now a good skater who plays hockey with the Halifax Hawks. His resulting confidence has made him much more willing to try new sports and activities. Eric's big brother and sister are very proud of Eric's skating and skiing ability – we now enjoy these activities as a family. Cool toys are a magnet for other children. Try to interest your child in the toys that his peers are playing with. Teach him to play with them appropriately. Eric's big brother and big sister participated in his therapy from the beginning. As a result they really learned how to help and teach Eric. They are wonderful models for teaching daily living and friendship skills to Eric. We are very open about Eric's autism. It is important for people to understand that it is Eric's autism that makes some of his behaviour odd and frustrating. With that knowledge comes understanding, and a willingness to make an extra effort to engage Eric in conversation or play. We also provide written information about Eric to his teachers and coaches. Our letter begins as follows, “My Mom and I are writing this letter so that you will know about me when I start school in September (or when I start hockey in September)”. The letter lists his likes, dislikes, learning style and other things that people should know. Pick playmates carefully and make sure that they have a great time when they visit. Good food and fun activities usually ensures that they will return. Practice planned activities with your child before the play date. Don't put your child in a situation where he is likely to become overwhelmed or fail. What's the point? I always consider the number of children, expected noise level, and expected activity level. before committing Eric to an activity, party or event. Provide tools to help him cope such as requesting a break either verbally or with a break card. Use songs and games to help teach your child new skills or to tolerate certain activities. Eric could not bear having his nails cut until we made up a ‘click and kiss’ game. The game is both fun and distracting. Read More than Words by Fern Sussman (The Hanen Centre, Toronto, 1-416-921-1073, ISBN 0-921145-14-4). It's full of good, fun, creative ideas for children at all stages of development. Demand that your child be treated with kindness and respect. Accept no less. Provide a loving and secure environment. Don't hire anyone to work with your child that you or your child dislikes, regardless of their qualifications. In closing, be the best parent that you can be so that your child can become the best person that he can become. Remember, your child has a disorder that not only makes him different, it also makes him unique. In our efforts to make our children conform to our ideals, we risk taking away their uniqueness and individuality. Focus on your child's relative strengths, not just his weaknesses. Love, laugh, embrace, persevere, and be confident that your child will continue to learn with HOPE.

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