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How we are preparing children with Autism for high school and college.

Our primary work is early intervention for Autism. However;as our practise matures, we find that some children whom we discharged many years ago, (children who joined mainstream schools) are reaching out for help to prepare them for the rigors of college life.Depending on the child's profile, extent of support received in school; children reach out to us at different stages in their school life. Either as they head into middle school or at high school.The work we do lays the foundation for college life. I will be honest in saying that we are building as we go along. This is an area where we have had to do a lot of reading, planning and

preparing children with Autism for college
With Dr.Patricia Prelock LA, 2017

learning on the job. I was particularly fortunate to attend Michelle Garcia Winner's workshop on Social thinking at San Diego in 2012. In 2017 at the ASHA conference in LA I got a chance to hear and interact with Drs. Patricia Prelock and Tiffany Hutchins.Their work on TOMI (Theory of Mind Inventory) has guided our work. Recently my friend Dr.Siva priya Santhanam (University of Denver) shared her paper on the role of Speech and Language Pathologists in Understanding and Promoting Self Advocacy in Autistic Adults. We will need to develop these skills as our children grow into young adults.

One of the major challenges that we have seen includes difficulty with perspective taking.This can manifest in many ways. Eight years old Mahek for example could not understand why her mother was unable to cook her favourite foods all the days of the week. Life was so much in black or white that she couldn't understand why the maid at home was not adhering to the rules of her employment. If the maid was being paid to work 6 days a week, with a day off on Sundays; why did she not turn up for work on a Wednesday (when the maid was unwell)? Issues like these , had the potential to throw Mahek off keel and she would often have major meltdowns. At sixteen, Aniket does not appreciate when his listener has lost interest in the topic that he is talking about. He does not appreciate that his interest in cars may not be shared by all. Another challenge he has is in not giving a context to his communication partner (listener).

Sometimes children's reactions can be disapproportiate to the challenge they may be facing. Few are overly competitive and cannot handle standing in second place. Not seeing the greys in life can manifest in many ways.Mahek for example would cry for hours on end if her teacher made a mistake in class. Teachers know everything, how can mine make a mistake? Aniket had to be the one to raise his hand for every question that was asked in class. All hell broke loose if he was not able to for some reason.Our work includes sensitizing children to the size of the problem and practising a response that is proprtionate to the same. Step by step, with great systematicity, they begin to understand this.

There were few others who did not have the vocabulary to express the entire range of emotions they were experiencing. For example- disgust, irritation,guilt etc. Recognizing your emotions is a critical life skills.People who can recognize their emotions and calm themselves down are better equipped to have healthy relationships and manage difficulties and setbacks of day to day living.

Higher order perspective taking are other challenges that we help children with.The Theory of Mind Inventory helps us to appreciate the nature of these difficulties. For example not understanding that people can smile even when they are not happy. Not knowing the difference between teasing and bullying. One of the children was bullied into bringing money from home for his bully. This child started stealing from his grandmother (out of a blind trust in his bully).This went on for a month before the parents tuned in and took corrective measures. As teenagers become more sexualy aware, they begin to explore.Many nuerotypicals will watch videos and encourage their peers too.Children can be quite cruel sometimes. For example, one of our children needed to learn that his classmates were leading him up the gum tree when they encouraged him to touch the househelp inappropriately. Without such understandings, we will face instances of inappropriate touch that has the potential to lead to social ostracisation.

The child with Autism will needs to be educated on private versus public thought. Imagine telling your favourite girl ( who thinks she is looking like a million bucks) that This dress makes you look fat!. At the highest levels, perspective taking includes knowing that our previous opinion of others influences how we interpret their behaviours.It also includes the understanding that people will lie to mislead when someone makes a guess they are less certain about the facts. It is easy to appreciate how an individual with these challenges can be gullible, susceptible to bullying and cheating. These are important life skills that help us also to negotiate relationships and be successful in them. The foundations for which are laid pretty early in life. Being able to tell a lie (prevarication) for example is first seen around age six but continues to develop and refine right through middle and high school.

I will refrain from making this a laundry list of challenges and instead focus next on how we helped. While the TOMI provided us a framework to understand the challenges, Winner's work guided our intervention strategies. We introduced the concept of thinkables and unthinkables. We also introduced the concept of Super Flex, comic book heroes whose thinking strategies could be emplyed to overcome

socially unthinkables that might be invading our brains. We helped children

recognize these strategies in stroy book characters. Next we helped them understand when unthinkables were invading their brains and finally practise letting the thinkables (positive strategies) take over. What were the changes we saw ? Mahek can play with her three your old sister.She is able to understand that her sister would not look at the games and participate in the same manner as she (a much older kid) does.Mahek can come down to the sister's level. Mahek can talk herself into staying calm even when Teacher makes a mistake in class. She appreciates that the fun is about the game and not in the winning or loosing. Aniket has learnt to temper his remarks on how other people look. Here is what one of the kids wrote about the strategies he is employing in his life.(see pic)

Preparing child with Autism for college
Child lists the strategies he uses

Mahek told us , I ate my food even though I did not like it because I understand that Mama is busy. Activities to help with sportsmanship included sportsmanship checklists, stories on good vs sore loosers, watching videos to identify good vs poor sport. It was heartening to hear the child tell us that he was satisfied with himself because he was a good sport. That playing by himself is not fun, the pleasure is in the company.

What do other people think of me

Stories, video modelling, thinking and speaking cards are some of the strategies we employ to help children appreciate non- verbal communication. Imagine going through college not appreciating that the listener has lost interest in what you are talking about.We also practise recognising a range of emotions both in themsleves and others. Thanks to what our children have taught us, we now introduce an entire range of vocabulary related to emotions at a very early age, during the early intervention years.

As children develop their skills in perspective taking, the changes we see include voicing opinions. They take more interest in what others are saying, even when the topic is not concerning them directly. It is rewarding when parents tell us that My child is thinking for himself.

In the early years, most parents are focussed on getting the child to join and sustain mainstream school.However, it is important to continue to mentor them through middle and high school.Sensitizing caregivers towards mentoring to develop the higher aspects of language, critical to successful integration into life is an important aspect of the work we do. As we learn, we look forward to sharing our learnings and learning from you. Please do leave your thoughts and comments.


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