Sunday, January 27, 2013

Removing barriers to engagement

Some time ago I wrote about barriers to engagement with children who have Selective Mutism, now I have been thinking on a follow up post to give those working with children or who are parents how to approach each situation with a chance of success.

While reading on a facebook page called the Autism Discussion Page in a post I read
"Parenting a child with autism often means wearing multiple hats (mother, father, therapist, teacher, researcher, advocate, social mediator, biomedical doctor, etc.). You have to continually multi-task to keep up with the chaos. Parents of young children on the spectrum often have an overwhelming sense of urgency, to do as much as possible to help their child overcome their challenges and develop and grow to their maximum potential. This is very understandable and recognizable in many parents of young children. However, we have found that often we move too fast in our urgency to provide for our children. The world moves way too fast for these children, and we need to slow it down to maximize learning."
Now I have to mention this paragraph because it was this that caught my attention after my recent post at the end of it all, I choose who I am discussing my heart ache when it comes to parenting a child with special needs and the demands it places on the parent. This small quote speaks to me also of the pressure we feel as parents to intervene in our children's lives to help our children to "overcome their challenges and develop and grow to their maximum potential".

For some time now I have been trying to understand what is different about how people interact with children and why do some people have a large amount of success and others don't. From observing parents who interact with my son I have noticed parents in particular who have children with autism actually seem to be able to engage with my son on a different level and make a large amount of progress in social interaction with my son in a short amount of time.  This puzzled me as to what the difference was, until I read this discussion on "declarative and imperative language"
"When using words, use more "declarative language" instead of "imperative language." Imperative language is any statements that direct a specific response from a child (questions, directives, instructions, prompts, etc.). Declaratives are any statements that invite, but do not direct a specific response from the child (statements share information, ideas, thoughts, feelings, experiences and perspectives)."

Now I don't know if this is a major revelation for any of you, but this totally relates to children with Selective Mutism. The nature of their diagnosis is anxiety and often the very style of therapy and interactions most people use with children actually makes their situation worse and they retreat further into their shell. If you struggle with anxiety being put on the spot and asked questions such as how are you today, say thankyou, say please actually increases the anxiety rather than reduces it. It is so frustrating to watch well meaning people who want to engage with my son sabotage the situation by not understanding these concepts. Relating to Selective Mutism, there is also a theory around communication load which supports this concept. 

In the past I wrote a short blog article on the topic of "communication load" the way we communicate has a direct relation to the impact and success of encouraging a child with Selective Mutism to speak, Maggie Johnson describes the Communication Load in terms of low, medium and high and also provides a description of activities that fit into each category, I have written a post on this topic with slideshow like pictures to describe the concept, please check out communication load revisited here before you continue!

"Normal interaction between two people usually consist of about 20% imperative (questioning, directing) and 80% declaratives (sharing ideas and information). However, when we interact with children on the spectrum the ratio is turned around; usually 80% imperative and 20% declaratives. Children on the spectrum tend to freeze up and resist imperative language. They tend to have strong "performance anxiety" and pull back from imperative (directive language). Just like us, no one likes to be questioned, prompted, directed all the time."
No surprise when reading this we actually find the same with Selective Mutism, when people don't pay attention to how they communicate and invite and encourage speech, it is so easy to be caught in the trap of questioning and directing rather than declarative language, this can also be described as commenting, statements talking as though they might respond but continuing if they don't take the opportunity. I wonder how much of our interaction is based on how we feel rather than how the child feels. It is incredibly confronting when a child doesn't respond verbally when we want them to. This author goes onto discuss how we can change or rephrase the way we speak it is also similar to the concept of open ended or close ended questions. He then makes the claim that we can "usually get three times more interaction from the child when we use declarative language."

Once you have considered how you speak, the next stage is to actually consider how you respond when waiting. A popular concept with Selective Mutism intervention is to freeze the moment this applies to allowing your child to respond and letting them experience the space in conversation so that they have more of a chance to speak up. So once again reading this short post I find another concept that is also applicable to Selective Mutism treatment.
"Learn to pause and wait! Children with delayed processing need time to respond. They have to process what is coming in, appraise what is needed, and formulate how to respond back. In our haste we often jump in and continue to prompt, or respond for them. Waiting is the hardest thing to do. It is much slower than our nervous systems want to wait for. It tasks patience and practice, but is very important. Slow it down, and give them a chance!"
If you also add into the equation speech delays and disorders it is even more important to slow down communication and responses. Giving your child time in the therapist office or in your company to respond in any given situation will make a big difference. Let's not allow our hurried lives to also run into our relationships with our children, students and clients. The challenge is while you are interacting with your child, how do you do it? are you putting too much pressure on your child by attempting high load communication activities before they master the low load communication activities? Slow the process down and take the time your child needs and desires. I hope all the information I have provided in this post won't be too much but I feel these concepts adequately describe how to encourage communication with any child regardless of their diagnosis.

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