Parents can help develop critical play and social skills in their autistic child

One of the greatest joys of becoming a new parent is watching your baby grow, develop, and hit his developmental milestones — such as holding his head up, sitting, standing, walking, and uttering first words. Most children reach these milestones at similar ages, but sometimes ages can vary. In some instances, children may not meet their milestones at all or may stall in their developmental progression, or show more subtle delays in social interaction or language milestones. These children may go on to be diagnosed with a neurodevelopmental disorder.

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder primarily characterized by deficits in social communication and the presence of restricted and repetitive behaviors. Deficits in social communication and interaction include difficulties with sustaining conversations, imaginative play, and problems interacting with same-age peers. Examples of restricted and repetitive behavior include repeated motor movements, distress in response to changes in the routine or environment, highly restricted interests, rigid thinking patterns, and abnormal sensory reactions.

According to Amy Lemelman, Ph.D., an assistant professor of psychology at New York-Presbyterian Hospital Westchester Division in White Plains, “ASD can be reliably diagnosed in toddlers, which leads to earlier access to treatment and intervention.”

Early intervention is key to improvement: a parent’s guide

Early intervention using behavioral and naturalistic treatments can result in improvements in functioning. Family involvement is also critical. Dr. Lemelman says, “Parents, siblings, and other caregivers can incorporate teaching moments throughout the child’s daily routines to support the development of social engagement, play skills, and appropriate behaviors.”

Some strategies:

Become a play partner: Children with ASD or social communication difficulties often have delays in their pretend play skills, and when they do engage in imaginative play, it tends to be less complex. Adults can take extra steps to provide them with the opportunities and encouragement they need to learn these skills.

“Pretend play is a critical part of children’s development,” explains Dr. Lemelman. “During the process, they are building important language, social, emotional, and problem-solving skills.”

One approach, known as the Early Start Denver Model, works on the premise that caregivers can help their child expand play and communication skills by meeting them at their developmental level and building on their strengths. Parents can engage their child through the activities they enjoy. In effect, they enter the child's world through play by following the child's lead. In this model, therapists act as parent coaches, teaching parents how to direct their child into increasingly complex interactions.

Become a teacher: If a child with ASD has trouble communicating his wants and needs, it is tempting to want to do everything for him — dressing, feeding, etc.

“This compensating behavior does not give the child a chance to show that they can do things on their own,” notes Dr. Lemelman. “It is important to scaffold new skills that the child is learning by using prompts. Whether these are self-help, play, or social interaction skills, parents should begin teaching these things by providing more prompts initially. As the child learns these skills, let them be more independent by fading out your prompts.”

Adjust your language level: If a child with ASD has few-to-no words, using single words is the easiest way for a parent to be understood by their child. Combining gestures with your language or showing the object that you are talking about will help bring meaning to new concepts for the child.

Dr. Lemelman says, “Parents can use the ‘one-up’ rule, which involves intentionally speaking to their child with one-to-two more words than their child uses consistently. For example, if their child says ‘ball,’ spontaneously, the parent can say ‘ball rolls’ while interacting during the activity.”

Let their voice be heard: Once a child with ASD has developed more language skills, it can be helpful to make an effort to stop talking for them. “By pausing during activities and waiting for your child to speak, you can encourage him to spontaneously make requests, ask questions, initiate interactions, and continue conversations,” says Dr. Lemelman.

Follow their lead: Allowing your child take the reins during play can have numerous benefits, especially if you copy or imitate what they are doing. Let your child choose the toys and spend time observing what he does with them so that you can do this as well. “This can have numerous benefits, which include increasing your child’s attention to you and building his awareness of you as a social interaction partner,” explains Dr. Lemelman.

Encourage interaction: Encourage your child to interact with other kids. “For example, bringing him to group events such as children’s events at the library can expose him to good peer models,” advises Dr. Lemelman. “For older children, you can set up play-dates that are time-limited and focused around a specific activity, such as baking cookies or building a Lego set together.”

To learn more about our services for autism spectrum disorder, visit nyp.org/psychiatry or call 914-997-5848.