Who am I?
First, I want to tell you that I am not an expert on child care and diagnosis of behavioral or developmental problems among kids. These are just my opinions and experiences as a child care provider and as a registered nurse in our center.
Last year, I and my friend, a special education teacher, decided to set up a care center for children with absolutely no knowledge or realistic expectations of what's in store for us. Little did we know that caring for toddlers will take us to a roller-coaster ride of experiences that will help us grow as early childhood educators and care givers.
We work closely with developmental pediatricians, health care professionals (when needed), speech and occupational therapists. In the future, we would also like to work with other child and day care centers, behaviorists and other professionals in our locality to properly profile all children aged 4 y / o and below and gather data enough for researchers, policy makers, and students to use for study.
The Modern Toddler
At our center, we cater to regular kids and those with special needs. Most specifically, those with Autism Spectrum Disorder (ASD) and the hearing-impaired. In this article, we will mostly talk about ASD and how we deal with our kids on a daily basis.
It is not a secret that today's toddlers are far more well-adapted to technology than we were ever used to. And this, to an extent, is a positive achievement for many of us who used to only "dream" about technology, watch about it on bulky TVs, or read about it in encyclopedias and almanacs.
However, on the flip side of the coin, the same technology is making many of our kids less sociable and thus, many have developed behavioral and developmental problems. In our child care center, since August , 3 out of 10 of our kids still do not talk by age 3, and the same ratio of kids display characteristics of autism spectrum or some other disorder (no eye contact, little-to-no speech , lining things and toys, tip-toeing, meltdowns, diminished social skills, solitary play, aggressive behavior, repetitive talk, play, and actions, head-banging, etc.).
Kids with special needs do best when they are integrated with kids who do not have developmental or behavioral problems. Play and peers are very important in helping them open up more and eventually learn to communicate their wants and needs.
Diagnosis and After
Upon noticing ASD characteristics on a child, we invite both parents to show them how we assess the child's basic skill sets and the signs or characteristics that we noticed with their kid. At the end of the session, we ask them if they would be interested to visit a developmental pedia in the city.
The doctor would usually suggest one or a combination of the following:
- test for hearing (to rule out impairment),
- continuous child care (to improve socialization),
- speech therapy (to improve or correct speech),
- occupational therapy (to improve dexterity, control, and mobility), and
- some other specific medical and psychiatric tests,
- follow-up on a specific date
It is fairly easy to spot children who are "at risk". Absent or limited eye contact and speech at a certain age usually mean that something is off and is usually the first thing that we notice among our kids who have ASD.
The most difficult part is not identifying these characteristics, rather, letting the parents know about the possibility of a developmental problem. Denial and resentment are things that many parents undergo, but we make sure that we are with them every step of the way. If they declined any referral to a developmental doctor, then we do not hold it against them.
It is important for us to convince these parents and guardians to make sure that high risk children get to visit professionals who could then correctly diagnose them immediately, but it is also important to consider their feelings and their right to decide for their children. Knowing the diagnosis is essentially the first step to understanding, reaching out, and communicating with a child who has ASD.
Initial diagnoses are not always absolute, even doctors need plenty of time to administer tests and to work with other professionals to come up with a correct diagnosis and suggest the most appropriate management for the high risk child.
Ways to Try to Communicate with Kids with ASD
1. Face the child while playing or teaching something.
Children with ASD typically practice solitary play and may seem like they are not interested with us caregivers and the other children. Most, if not all of our "high risk" kids were initially absorbed in their own worlds and did not really like interacting with playmates. Facing the child provides you an opportunity to enter their world and participate in the child's play.
2. Catch their attention when you want to say something to the child.
Facing the child, tap his shoulder and call out his name if you want to show or tell him something. You may even hold his face and look at him directly until he does the same and looks back at you.
3. One command or information at a time .
Teaching kids with limited focus can be really frustrating at times and it is best to keep things simple. Build their vocabulary by teaching them one word at a time. Observe what they like doing "at the moment" and base your lesson on that stimuli.
For example, one time, I noticed one of our kids with mild autism was quite interested with how I rolled the pencil repeatedly on the table. I knew I caught his attention because he was giggling as the pencil moved along over and over and he was looking at me expectantly. I then stopped, held the pencil and said, "ROLL" while showing him how it was done. I rolled it again and then held the pencil a little longer this time to see if he would get my hand and motion for me to do it again. To my delight, he said "ROLL!"
4. Stop when the kid is uninterested.
When the kid is unable to sit still any longer, stop and give him something different to play with. If nothing catches his attention, sing his favorite song! Additionally, if you notice him reverting to repetitive speech or actions (like running to and fro), distract him with toys or hold his face, call his name and catch his attention to break the repetitions.
It is also important to note that some kids with ASD may appear uninterested, but are actually listening to whatever you are saying while they are busy doing things on their own. Each child will display a different "bored" cue and it is important to recognize this and give them plenty of time to rest.
5. Be generous with praises and be consistent .
Sitting still, following simple instructions, longer eye contact – all of these are tasks and milestones. Make sure to praise and congratulate the child for being successful and for trying even if it can be very difficult at times. On the other hand, correct bad deeds and explain why it should not be repeated again. Kids learn when you help them follow rules consistently and when you gently explain the reasons for such rules.
6. Employ the different senses.
Sensory integration is important to kids with ASD. The sense of touch is a very powerful tool in catching their attention. This is why massage and gentle pressure are done by therapists to make the kids focus better.
Look for ways to keep the activities fun. Music and dance are popular among those who need to move about all the time to focus and in our experience, these two activities never fail to get them to participate during circle time. They especially love action songs and we would make them listen to these songs for days until such time that we see them having fun.
Sand trays are also excellent ways to stimulate their senses of touch. We use them for tracing shapes, numbers, and letters as well.
7. Involve regular kids in their play / activities.
Toys and understanding playmates are important to any developing child. In our center, we have a two-way task of making our ASD clients feel comfortable and teaching our regular kids how to be more patient and understanding with their classmates who have autism. Toddlers are naturally selfish at first, but with constant reminders and guidance, they learn to value their friends and build good relationships with all of their playmates.
These are only some of the things that we do at the center to get our kids with ASD open up a little, focus better, and "communicate" what they want using words. It takes painfully long to get them to learn new words at times, but they can still communicate in lots of other ways. Crying, pointing, holding and directing your hand to do something – all of these are means to communicate!
Importance of Early Child Care and Education
Providing all kids (especially those with special needs) with early child care and education is beneficial for early intervention. Trained professionals can easily spot developmental and behavioral issues among toddlers.
However, not all early child care and education providers are created equal. They must be gentle, consistent, and compassionate and the service should mirror what a child would learn in a healthy and loving home.
Parents should never feel that they have shortcomings for leaving their children in a day care or child care center. The center staff, classmates / playmates, and the parents can collaboratively provide the best environment for ALL kids to grow and learn optimally.