Monday, April 1, 2013

SHADES OF AUTISM #3: EXPRESSING EMOTIONS ARTICULATELY

AL - Part 2

There is something which we all do, that keeps children from expressing their emotions articulately. 

When a child gets hurt we say, "It's ok" then move on, and act as if the bump or fall was nothing, or never even happened.

Many children will cry even harder, because they are thinking, "It's NOT ok!" "My leg hurts A LOT!" "Don't you UNDERSTAND?"  

Children with communication delays or disorders will most certainly cry louder, because they are trying to communicate their pain, and (in their eyes) the message is NOT being understood.
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AL's mom was intent on avoiding him becoming upset.  She became the best at saying, "It's ok, it's ok, it's ok," and distracting him. A year and a half ago, the tactic worked most of the time, but as he got older, his upset began to escalate.  

One day I walked in for my session and she said, "He cried for over an hour today, after he got upset."  "He's crying every day now."  "I don't know what to do."

When I witnessed AL becoming upset he would run to the couch, lay down and cry as if in agony...a howling cry.  Sometimes he would lay on his back and cover his face with a small square pillow, as the tears streamed down the sides of his face.  

When frustrated or upset, he didn't use gestures, pulling or pushing to get his needs met.  He would remove/isolate himself.  Then his level of functioning plummeted, as he communicated as an infant would...through crying.

AL had a great deal of trouble initiating speech (speaking spontaneously).  The thoughts and emotions were there, but he could not express them volitionally or articulately.

One day, when he became upset, I began doing some "I - Voice Talking."  
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Side Note:  "I - Voice Talking" is something I developed spontaneously one day, around 1996, when a boy named Stephen, in my preschool class, began to cry as his mother left the class to head for home. As Stephen cried, I said (in a loud voice - so he could hear over his crying), "I want my mommy to stay here with me!  I feel sad.  I don't want my mommy to go.  I want my mommy to stay!"  

Stephen stopped crying for a minute and looked at me, as if to say, "How can you read my mind?"  He also might have been thinking, "Finally, somebody understands me!" He calmed down because he no longer had to keep trying to communicate what he wanted or how sad he felt. 

Over the years I put that term, "I Voice - Talking" on many IFSPs at NJ Early Intervention meetings.  Soon, the Service Coordinators who attended those meetings began to suggest the technique at other meetings, for children who I didn't even know.  Often, I would be called in to do a consultation or help out with a case, and when I looked at the IFSP and saw that term, I smiled.  
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 So...I went over to AL (who was now on the couch, with his Dad near by) and said aloud, "I am so angry and frustrated! I want my toy back!  I feel sad!  Daddy, I need a hug!"  

Remember, AL has Autism.  It takes him time to become accustomed to new things.  He seemed a little calmer, but not much that day.

I explained the "I - Voice Talking" technique to his parents, and assured them that it would help him.  I reminded them, as I always do to parents, NOT to ask questions like: "Are you ok?" "Are you sad?" while using the technique. 

The point is to SPEAK in the FIRST PERSON ["I"] voice (aloud),  whatever you believe the child is THINKING or FEELING.  This lets him know that you HEAR and UNDERSTAND what he is trying to communicate.

When I returned a few days later, his mother said, "Noelle, when you explained how to stop the crying, I didn't agree.  My husband didn't agree.  We thought he was misbehaving and we should use Time-Out or something like that.  But, these past few days I tried it your way, and I see it's working. He isn't crying for long periods of time.  It's getting better." 

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The other day I was working with AL's brother, after I had already finished working with AL.

AL entered the room, holding his mother's hand, and started to cry.  His mother asked him, "What's wrong?" and he ANSWERED, "Scoop," as he struggled to speak through the tears.  She said, "Ok. Let's go get Scoop," and led him to get the toy from his sister, who was playing in another room.

Months ago he would be howling on the couch.  That day he showed the ability to communicate while upset.  

I can't wait until he can speak without crying and say something like, "I feel sad because my sister took my toy."  Maybe he will then problem solve, "I want her to give ME a turn in a few minutes."  

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Using "I - Voice Talking" helps children hear what they can say when they are feeling emotions.  It can also be used in other ways.

Let's say Mary does not want to share a toy with John.  If you tell Mary, "It's John turn," and then say, "Here, John. Take a turn." Mary will likely hold out the object to John.

If a child gets upset every time you change his diaper or wipe his face try this.  Say: 

"Thank you, Mommy.  Thank you for cleaning my nose" or 

"Thank you, Mommy for keeping me clean.  Thank you for changing my diaper."

The child will not fuss as much.

This demonstrates to the child that he should be grateful for what you are doing, and it works.

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Once I went to do a behavioral assessment.  The child didn't speak, and while I was there he needed a diaper change.  The mom said that he was impossible to change; that it was like a wrestling match.  

I explained what I wanted her to do, and accompanied her to the changing table.  He began to thrash around, and I modeled, "Thank you, Mommy."  The mom joined in and we bombarded the child with "Thank you, Mommy."  

At the end, when the diaper was on, that little boy said, "Thank you," while looking up at his mother.  They were his first words.  We were both stunned.  All I was looking for was for him to remain a little stiller, and he actually spoke.  That was a very good day.

I am Noelle Michaels.  I'm a speech and learning specialist who enjoys helping families brainstorm new ways to help their children.  Please reach out to me, if you would like any advice or information.  I'm always glad to connect, because I truly love my job! 

I am available for families in the North Jersey area to do a FREE 30-minute consultation. 

I am available via email or phone, and will speak to any parent or professional with questions or concerns.  Let's work together to help children speak and learn at higher levels! 

 
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Noelle Michaels, MA, CCC-SLP, LDT-C
Bilingual Speech Language Pathologist
Special Educator & Learning Specialist
Email: noellemichaels@hotmail.com
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