Pre-academic skills - The first skills a child with autism needs to learn

Every child has a right to learn and gain knowledge, weather he is a typical kid or a child with disability. Learning does not starts and is not limited to going to school and academic knowledge. A child is ready to learn academics once he has attained the core pre-academic skills. Even before going to school, typical children learn a lot from their surroundings, by observation and as natural part of growing up. For children with autism the teaching process starts a step before. Children with autism do not naturally develop skills required for learning. They need to ‘learn how to learn’. Learning happens when the child is able to attend to a task and sit for some amount of time with a teacher.  Before starting with academic teaching, it is important to work on building the core skills required for learning. Some of these pre-academic skills are

1. Attending: children with autism generally find it difficult to attend to a task. They may not be able to filter out unnecessary stimuli and give attention to more important activity being performed. E.g even if you are trying to have them participate in a block game, they may be engaged in looking at the moving curtain. Our children lack joint attention where typically kids follow the line of vision of other person to look at the thing that the other person is looking/doing. For them attending has to be a learned skills. Attending skills can be improved by slowly increasing the time spent at an activity and pairing with preferred activities.

• Make the environment as less distracting as possible. This may require setting up a place with less furniture and display items or removing things that may distract the child. 
•  Identify the activities or things that the child is most interested in. They may not just be typical toys but things such as string, shaving foam, music or bubbles. 
•  Pair the child’s preferred activities with other activities. Try to engage the child in an activity for some time and then change the activity if needed. The child may have different threshold levels for different activities depending on their interest. Initially, it could mean just doing the preferred activity of the child and then slowly transitioning him to other activities for short period of time. My daughter is very interested in music and my work time with her includes lots of rhymes with actions and facial expressions to sustain her attention in me. 
•  When the child wants to leave an activity try to keep him for one more turn. Don’t make it a stressful situation. If he wants to leave the activity midway, help him complete the activity with full assistance (like hand over hand). 
•  Develop familiar games and routines. Keep the length of activities short (maybe increasing later with time) to reduce frustration.

2.    Sitting Behavior: our children may not sit at the place easily. Developing a sitting behavior is essential for learning. To develop a sitting behavior, start slow and gradually increase the sitting time. E.g if a child can sit for 5 mins, the first target can be to increase the time by 7 minute.

• Identify a set of motivating things for the child. These are called ‘primary reinforcers’. Out of these as well, there could be an item which is most motivating. That would be the highest reinforce (e.g out of chips, bouncy ball and video, video may act as highest reinforcerment). It is advised to prefer tangible reinforcers (which would finish on its own like food items) rather than non tangible ones which are required to be taken away. Primary reinforcers should be paired with social praise. 
• Sit with the child along with a preferred activity. It could just be singing a song, reading a picture book, or sand play. Reinforce the child’s success in sitting for 5 minutes by praising him –‘good sitting’ and giving him a reinforcer. And continue for another 2 minutes of sitting for an activity. At the end of target time give the highest reinforce to the child. Pair the tangible reinforce with social praise. 
•  To encourage the sitting behavior, follow the child’s lead and make the sitting time interesting by using motivating activities and changing activities as the need be.

Attending and sitting skills go hand in hand. If the child attends to a task, the sitting behavior improves. When starting out working with the child, it is most important to build a positive rapport with the child and make the interaction fun and least stressful. It may be needed to just sit and play with the child and not introduce any new skills at all for quite some time for developing the sitting and attending behaviors.

3.   Developing eye contact: Poor eye contact is one of the core symptoms of autism. Improving eye contact is not just important for learning process but is also a very basic social and communication skill. While working with the child make an effort to get an eye contact with him.

• Sit at the eye level of the child. Even while talking to the child or giving instructions bend down at the child’s eye level and then talk. 
•  If the child is looking away, move in his line of vision rather than moving his face towards you. 
•  Always appreciate his efforts to make an eye contact. When he looks at you, smile and say ‘good looking at mumma’. 
•  You can use motivating things to encourage eye contact. E.g hold a favourite toy right in front of your face to encourage him to look at you or cut a hole in paper and make a game of looking through it in turns. With Tuhina I use songs and rhymes to encourage eye contact. She looks very intently at me while I am singing and I smile and appreciate her looking. 

4.  Following basic instructions: if the child’s receptive language is much delayed, following teaching instructions may be difficult. Before starting with table top learning, it is important to develop understanding of a few basic instructions which could help the child in responding to you. Instructions like ‘touch’, ‘give’, ‘pick’, ‘point’  tells the child a way to respond.

• Make instructions very short and clear. Instead of saying ‘give the car you are holding to me’, just say ‘give car’ and hold out one hand. 
•  After giving instructions wait for a few seconds and if the child does not respond, follow through the instruction by guiding him physically to give the car in your hand.

5.   Turn taking and waiting: turn taking and waiting is also a learned skill for children with autism. These concepts can be taught using very simple turn taking games and activities like banging on a drum with a stick one by one.

• Play very simple turn taking games 
•  Use turn taking and wait cards 
•  I found the use of count of 5 or 10 very effective for many situations. If Tuhina is holding onto a toy which she does not want to give up after her turn is over, I usually tell her that she has to give it back after count of 5. Then after counting till five I ask for it again and gently take it if she still holds on to it. This works wonders as it sets a prior expectation of what is going to happen and reduce tantrums. It also works great in situations for waiting and ‘hands quite’, which is also a challenging task for our kids.

Even if the child is older than pre-primary level and finds difficulty in these areas these are the skills that should be targeted first. Many of these skills can most effectively be practiced in day to day settings and interactions. There may not be easy and quick ways but there sure are ways. And who knows it may not as difficult as first anticipated. Never underestimate the capability of your child to surprise you.