Dear Friends and Colleagues,

I am very saddened to write this post letting you know that our dear friend and colleague, Kathie Harrington, passed away unexpectedly on Tuesday, March 19, 2013.

Kathie left a wonderful legacy for all of us with her passion for writing about autism. She touched countless lives of clients, parents and professionals through her private practice, books, blogs and international speaking engagements. In May 2012, she was honored to be the keynote speaker at the Florida Speech and Hearing Convention.

Kathie and I shared a special bond as mothers of children with special needs. I will miss her words of wisdom and encouragement to think outside of the box. There is a huge hole in my heart because I will never hear her say, "Hang in there, girlfriend" again. Kathie paved the way for many of us sitting on the other side of the IEP table. She helped professionals understand more about the joys as well as the trials and tribulations that parents go through when she shared her inspirational personal stories about her son, Doug. 

The following poem is a tribute to her strong faith, the way she raised Doug and how she treated her clients as a speech-language pathologist.

I Never Told My Son He Couldn't Dance

By Kathie Harrington, MA, CCC-SLP

I never told my son he couldn't dance.
I never thought he didn't have a chance.

I never told my son he might not read.
I only sought to plant the seed.

I never showed my son a star.
That, I felt, was way too far.

I never taught my son to fly,
But I gave him wings with which to try.

I never questioned God's intent.
I only hoped my time well spent.

We never know what life will bring.
I only know that I must sing.

I never told my son he couldn't dance.
That is why he had a chance.

Kathie's dedication to sharing her knowledge in the field of autism, helped us  " plant the seed" and  give children "wings to try."  Her time with us was indeed  "well spent" and her legacy will continue on in the hearts and lives of  her family, friends, clients, parents and professionals.  

Thank you, Kathie, for teaching me how to "sing."

Leslie Fauquet, MA, CCC-SLP, is president of OnlineCEUs.com Inc., based in Orange, Calif.

[Editor's Note: Kathie was such a valuable asset to ADVANCE. I know many parents and professionals have learned from her and applied her wisdom at home or in their practice. Always working ahead, Kathie had emailed the sixth post in her series on Power Words in February. We will publish that, her final post, Power Word #6, on Thursday, March 28. Her family has planned a memorial service to be held in Nevada. We'll post more information when it's available.]

[EDITOR'S NOTE: This is the final post in the Autism Spectrum Across Ages and Environments blog. Kathie Harrington, MA, CCC-SLP, passed away on March 19, 2013. A memorial service for her will be held in Boulder City, Nevada, at the Veterans Memorial Cemetery on April 19, 2013. If you would like to honor Kathie's memory, the family suggests supporting an organization near you devoted to autism education and treatment. For the past 2 years, Kathie has provided a lot of wisdom and support for SLPs and parents. This blog will be archived on the ADVANCE website for readers to continue to learn from her.] 

"I'm thinking" is natural, simple, and can generalize into any event or social situation. We all do it all of the time but we just don't make it fun and obvious like we need to for children with ASD.

This Week’s Power Phrase is I’M THINKING

I train children with this daily. Why, because it works. Because it slows them down, gives them pause, time to collect a thought, know what they're supposed to do, use inner language, and "I'm thinking" is very turn taking in nature.

"Here's how it works:

During anytime, any subject, any conversation, any therapy, or teaching instruction, either the SLP/teacher/parent/caregiver or the child is allowed to think. They simply place their index finger to their forehead and say, "I'm thinking," before they respond.

This is so simple but I wanted to draw you a picture.

• The child picks up on this power phrase very quickly and imitates it readily
• Tactile input is processed by pointing the index finger to the forehead
• Verbal input and expression is expanded as appropriate:
• "I'm thinking about . . .  (name an animal if categorizing)
• "I'm thinking about . . .  (if talking about an event)
• "I'm thinking that . . . would come next (if sequencing)
• "I'm thinking that I could have . . . (when discussing what alternative behavior)
• Use pictures/small items and take turns thinking what the character's are thinking

"I'm thinking" is a very powerful way for children with ASD to verbalize, take turns, interact, express emotions, use Theory of Mind, organize their thoughts, use inner language, focus, and have fun.

One day as a small group of students entered the therapy setting I was sitting with my back to them. I twirled around in my chair with an oversized wooden hand that had an index finger pointing straight out. (I'd found it at a craft show the weekend before) 

 "I'm thinking big thoughts today," I announced with a giant grin on my face, wooden index finger pointing to my forehead, "and they all have to do with something about my friend Mr. Humpty Dumpty."

Mr. Humpty Dumpty was sitting on the therapy table, smiling wide in his little plaid suit. He was ready to start therapy, as were all three of the boys who happened to have ASD.

The boys scrambled into their seats. "Can I use the finger first?"

"Can I hold Mr. Humpty?"

"I'm thinking big today too."

Questions and statements came flying as if ASD had been thrown to the wind. Perhaps, for a time, when we were all thinking together, it was.

"Speech pathologists make good things happen."

Work Hard and Have Fun

I thank my husband, Tim, for this lifesaving Power Phrase for our son, Doug. This was coined not for school, not for the home, but for the job. Work hard and have fun has been used every day for the past eight and one-half years as Doug walks out the door to leave for work.

This phrase is simple, short, direct, and memorable. It is visual, as you can see below, and repeated often.

This Week's Power Phrase is WORK HARD AND HAVE FUN

Doug didn't always have a bad day at work but didn't seem to find any fun in it either. He was working at a major resort on the Las Vegas Strip in the housekeeping department at the time. Every evening he would come home with another pouting, somebody's out to get me story. Frankly, it get's very tiring especially when the talk never seems to generalize from one event to another or from one person to another. (Generalization is very, very difficult for a person with ASD)

My husband and I had discussed so many events and behaviors, of Doug's and others, to death. One night my husband had disputed enough when he said, "Doug, you only have to do two things at work."

  "Well, what's that, Dad," growled Doug.

 "Work hard and have fun." Tim was short. Tim was direct. Tim was final.

 I listened and my eyes and my mind popped. That was it. It was that simple.

The next day I went to an engraving shop and got the plaque you see at the top of this page. It sits on Doug's desk for him to see as he leaves his room every day for work. He also hears it from either one or both of us.

This Power Phrase was mind changing, emotional changing, and changed relationships both at home and on the job. The power of a word or phrase used over time can and does enhance life.

"Speech pathologists make good things happen."

It is innate that children want to please the adults in their world. Children want to make us happy, but sometimes they don't. Sometimes, they can't because their disorder makes it impossible to do so on their own. That's where our bag of tricks come in and utilizing Power Words/Phrases like Excuse Me can be helpful.

The power of Excuse Me is most effective with high functioning children and adults on the spectrum. This population has a better understanding of vocabulary and language but does not identify other people's feelings and emotions known as theory of mind. It seems like the person with ASD just ignores other people at times or doesn't care about what they feel or think. This person is rude, crude, and he/she don't fit in. Pragmatically, they are from another planet. This is one of the main reasons why this population is bullied to such a high degree. This is why there is such depression and possible suicide.

This Week's Power Phrase is EXCUSE ME

Sammy was in the fourth grade. He didn't seem to care what anybody thought about anything. He'd slam his books on the floor or trip over another child's foot just because it was there, without apologizing. His teacher and all of the other children in the classroom had just about had all they could take and were exasperated. Because Sammy was on the autism spectrum and received speech/language service, the teacher asked me about a possible solution.

"Excuse me." That was my suggestion.

Here's how it works:

• The child performs a negative behavior
• The adult says "excuse me" in a firm, directed, dissatisfied manner to the child
• The adult immediately removes eye contact and does not acknowledge the negative behavior of child
• The adult moves on in the classroom or in the home (unless there is a safety issue involved)

Over time, Sammy learned that his negative behaviors were not going to get any attention from the classroom teacher or from the other children in the classroom. These behaviors were basically ignored. "Excuse me" also brought to Sammy's conscious awareness that somebody else was affected by whatever the negative behavior was.

• Sammy began using the "Excuse me" phase himself!

"Speech pathologists make good things happen."

FAVORITE is one of my favorite words and it is powerful. I use it all the time and you should too. It's one of Kathie's Dozen Power Words that you will want to share with parents. Read on and I will reveal a great strategy that most parents need to know because they struggle as they ask the question, "What did you do in school today?"

Children who are not on the autism spectrum can most often answer the question, "What did you do in school today?" But, to verbal children with ASD, this question is way too broad and overwhelming. It is what I'd call loaded. Consequently, those with ASD do no respond in any manner. They ignore the question. They might look away or they might change the topic.

The parent is asking the wrong question.

The parent needs to ask, "what was your Favorite thing in school today?'

Then, the parent needs to anticipate one word or a simple phrase as a response. After that response from the child, the parent must add, "my favorite thing was . . ."

The SLP will be popular with parents when this Power Word strategy is shared.

One might say you will be their FAVORITE SLP!

This Week's Power Word is FAVORITE 

Two of my favorite things: READING and WRITING!

The first scenario about this week's Power Word is for sharing. Favorite is also a Power Word that the SLP will want to use in the therapy setting on a regular basis. I found out very early in my SLP life as well as a parent that what my "favorite things" were also became my client's and my own children's favorites. I use the power of Favorite when:

• I introduce new words
• I know there is something a child fears
• I know there is something a child dislikes
• I know there is something that motivates a child
• I praise a particular behavior
• I make statements about my favorite things
• We compare my favorite things to the child's favorite things
• We compare peer's favorite things
• We guess what somebody's favorite things might be

Favorite thing

Post it

Smell it

Feel it

Taste it

Read it

Write it

Say it

Hide it

Wrap it

Mail it

* As an SLP and student, you can do anything with your Favorite things. Think of all the speech and language skills. They all start from one fun, fantastic, flavorful, forceful, and favorable word, FAVORITE. Use it.

"Speech pathologists make good things happen."

Learn why developing humor is crucial for children on the autism spectrum.

            As Rudy leads the team on the field for the final game, he says, "I've been ready for this my whole life."

            The coach of the Fighting Irish instructs his team, "No excuses. Do the work."

This Week's Power Word is EARN

Of all of the power words I've used over the years, EARN, is the one I use most often in probably ninety-nine percent of my therapy sessions across all ages and abilities. We all must earn as we learn and that is a lesson of life.

• Here are some of the ways I express to children how they must EARN (always use the

     power word, EARN, in the statement)

     You've earned it

     You've earned another . . .

     You need to earn one more . . . (expand the expected response to one more time in order

                 maintain and extend attention)

     One more time to earn your . . .

     Earning is fun

     You earn, I earn

     Mommy's turn to earn one (or another child)

     It's easy to earn

     Look at all you've earned

     Earn and learn

     Learn and earn

     Earning ~ earning ~ earning

     Your turn to earn

     Let's see how many you can earn today

     This is your day to earn

• Here is what children might earn for their responses

     Tokens

     Puzzle pieces

     Dinosaurs

     Spiders/bugs

     Bubbles

• the point is, what a child earns depends on what is motivating to him/her
• make an EARN and LEARN sign for your room/office
• when children are old enough to start counting real coins, use them
• use an exchange system that encompasses several therapy sessions for earning a number of tokens/coins/etc. in order attain a prize
• by using the power word, EARN, consistently and persistently, and by sharing it across environments, the child will understand that he/she must work toward a goal and that goals can be set and attained.

* * * * *

In 2005, Rudy was named one of the best 25 sports movies of the previous 25 years in two polls by ESPN. It was ranked the 54th-most inspiring film of all time in the "100 Years" series.

Wikipedia

"Since 1975 no other Notre Dame Football player has ever been carried off of the field."

Daniel Ruettiger, known as Rudy, EARNED that honor.

"Speech pathologists make good things happen."

• They teach a child HOW to learn
• They instill theory of mind (TOM)
• They enhance continuity
• They foster turn taking
• They improve predictability
• They develop key words/phrases
• They increase independent thinking
• They augment behavioral control
• They boost attention and focus
• They expand life skills
• They increase expressive speech
• They broaden social language
• They encourage independence
• They add to a child's vocabulary

I could go on and on with adjectives such as "These words and phrases: multiply, expand, soar, swell, proliferate, escalate, rise, mushroom, snowball, heighten, intensify, etc., etc.

This Week's Power Phrase What Would . . . Do?

What would (the child's favorite person, cartoon character, sport's hero, etc.) do? is meant to be more of a statement than a question because it is introspective from the child's point of view. This phrase works well with children on the autism spectrum that are mature enough to analyze what is happening and what their hero might do about it in their situation. (The pictures above this week's blog image are of my Humpty Dumpty and one of my dog's Mr. Higbee. They are two of my favorites/heroes.)

            Jimmy was a ten-year-old. He didn't like to share in a small group of children,

            in fact, he wouldn't. With adult prompts and over time, Jimmy learned that it

            was okay to share and that he would get the item back. The adult prompter, started

            by asking the other children in the group "what would their hero do?" Each child

            named their hero and the scenario played out with several sharing interchanges

            among the children. All of the children loved this activity and began using it

            spontaneously, including Jimmy. (This did not need the SLP as a member of the

            group each time, however, the SLP trained the classroom teacher and aide

            in the strategy.) Very soon the children took over and Jimmy learned several

            valuable social interactions and how to implement them.

Redundancy, practice, crossing environments, persistency, and consistency are all paramount in the success of power words and making them dance in a child's life.

"Speech pathologists make good things happen."

Teaching skills to children with ASD is not enough. Colors, months, dates, counting, are not what make a person successful and functional in the world. This series of Kathie's Dozen Power Words will assist children and adults with Autism ~ across Ages and Environments.

I'm a huge proponent of individual speech/language therapy when children are young and also when they do not have an understanding of HOW to learn language and HOW they can take that language to manipulate their various environments. It is our job, as an SLP, to teach a child on the autism spectrum HOW to use language.

At a recent IFSP I attended, the team placed their total emphasis for therapy in a natural, nursery-school environment for a non-verbal, 2 1/2 year old with ASD. My contract, SLP, was the only professional seeing this child on an individual basis directed toward appropriate developmental skills that were teaching him HOW to learn so he could interact more appropriately in the larger environment. Of course, the SLP was using a variety of stimuli at a pace the child could keep up with, but utilizing turn-taking, attention, choices, pausing, categorizing, sequencing, and always verbal.

When the parent expressed why he wanted more speech time (used the SLP's name such as "Katie Time") he said, "Because she is a storyteller speech pathologist. She can make my child want to speak."

I think that says it all, a Storyteller speech pathologist.

POWER WORDS can make a child want to talk. They can make you a "storyteller speech pathologist."

Here is a list of Kathie's Dozen Power Words that I will be blogging for the next few weeks. At first I tried to put them in order of priority, but that really didn't work because one is not more important than another. Then I thought about giving them to you in order of when I came to use them in my long history of working with the autistic population. That order didn't seem to matter. Ah, I had it, which word or phrase I'd used the most number of times. No. I decided it didn't really matter. If the word or phrase landed on my list, it was there for a reason and the reason was a good one; it made a difference in a child's and a family's life. That is good enough for me.

I hope I "sucked you in" as my son with ASD might say. He coined this power phrase that worked for him years ago. Be sure to come back the next several weeks to read about Kathie's Dozen Power Words/Phrases: when, how and why to use them with your clients with ASD.

Here they are in no particular order:

• Earn
• Stop
• I'm thinking
• Work hard and have fun
• What's silly about that?
• What would ... do?
• You choose
• Favorite
• Pause it
• Excuse me
• Who's the most proud of you?
• Your turn ~ my turn

Which one do you think I'll blog about first, next week, on Feb. 14? I have it written already and I won't change.

If YOU are the first one to leave a comment here and get it correct, I'll send you a copy of my new mainstream, romance novel, To Dance with Fireflies.

"Speech pathologists make good things happen."

My father was a huge influence in my life and ultimately, in my career. He was not a professional man. He was patriotic. He worked hard. He was kind and generous. He owned a café, The Red Rooster in Iowa Falls, IA.

I worked there, first as a dishwasher, then as a waitress, and what I loved most, as a fry cook. I learned a lot about all three of those jobs but what I remember most was the big, wooden, carved sign that my dad had specially made. It hung over the door just as one exited the kitchen and went out into the main dining room. Nobody could miss it and who would want to. In its simplicity, it read, "You're not dressed unless you're wearing your smile."

Pause for ten seconds and read the

words to this verse of

When You're Smiling

In last week's Autism Spectrum across Ages and Environments Blog, Just to See You Smile, I asked you, as SLPs and parents, to do some brainstorming and commenting about how to help people on the autism spectrum "get their smile." A smile is a social thing, you know. People on the spectrum have difficulty with social things to say the least. I'm going to dig in here and give you some ideas of how you can help. In fact, I'm going to say, you MUST help because it IS that important.

All of the following ideas/strategies are based on speech/language therapy. I'm going to share many things about what our family personally did and continues to do.

• Imitation of making funny faces in a mirror (always in a turn taking manner with the adult sitting behind or beside the child)
• Tickling (always to a similar theme - when our son was young we'd roll on the floor together and I'd say, "Doug, tell me your secret to thinness." I'd tickle and we'd laugh)
• Water play in a bucket - bath time for parents - pour, paint, play, sing, read
• Slapstick humor - watching the old Laurel/Hardy, Three Stooges, Andy Hardy movies TOGETHER.
• Favorite cartoon books - what is the child's favorite that is non-violent? Doug liked Garfield and we still have the entire set. We drew them. Talked about them. Wrote new ones. Do you see the WE here?
• What's silly about that? This is one of the most effective means of teaching a person how to look at a scenario and find a silly response. (my blog of July 21, 2011 describes this in depth - take a look)
• Taking pictures and looking at pictures of people smiling (discriminate between them)
• Use Photo Booth on an iPad and make goofy pictures of yourself and client
• Teach how and why smiles are part of communication
• Role play using typical peers discriminating between giving and not giving smiles to see how to elicit a smile back
• Put yourself in silly, verbal situations such as, "Today I rode my horse to school and could not find a place to park him."
• Put yourself in silly, physical situations such as, "I dropped my pencil and it's very heavy to pick up. It must weight 1000 pounds." (animation ~ animation)
• Let parents/caregivers know how important smiles are to overall communication
• Put a big SMILE sign in your therapy setting or carry one with you attached to a tongue depressor. Hold the sign up by YOUR face and smile back.

Redundancy ~ Daily practice

All team members ~ Include parents ~ Make it fun

Make it functional

It is social survival

A smile is contagious, infectious, catching, communicable, and transmittable.

I want all SLPs to go to one public place this week.

SMILE at two people at this place.

Do not smile at two people at this place.

Comment on this blog what communicative, kind, social, reciprocal results you find

"When You're Smilin'"

"Speech pathologists make good things happen."

 "This is my son, Blain. It was taken a couple of years ago. He rarely smiles in pictures or in life, so I appreciate this picture." (Copied from a post on Facebook 1-3-13, from the mother of a young man with ASD.) There was a picture of Blain (fictitious name) with a semi-smile that accompanied this post and I could feel the love and joy that radiated from this mother.

Children on the autism spectrum are usually beautiful people. They certainly use facial expressions during tantrums and let us know what they dislike but smiles and normal affect don't come easily. As they mature they can loose even more of the ability to smile, laugh, and communicate through the means of joy. Don't let that happen to your clients or to your own child

Pause for ten seconds and read the

words to this verse of the Tim McGraw song

Just to See You Smile

A smile is communication. I've never seen or heard of a benchmark on an IEP for teaching a person how to smile. Why not? I know that a smile can convey more than a ten-word sentence when it is properly placed, seen, and appreciated by another human being. Perhaps, it is the ultimate message in the Theory of Mind.

My July 28, 2011 Autism Blog, "Laughing at Language" tells the story of a little boy on a train at an amusement park. Please read it if you have not or refresh yourself. This was my son at a very young age and I knew then that I would need to teach Doug how to smile and laugh in order to communicate in a manner that most of us take for granted. I did.

• Is teaching smiles and laughter an easy task ~ no
• Is teaching smiles and laughter a "fast track" task ~ no
• Does anyone really know how to teach someone to smile ~ let's try
• Can smiling be taught as part of communication ~ YES

***** It is soooooooo important that YOU, the SLP and YOU, the parent, give adequate thought to this discussion. I hope that before I provide some answers next week, many of you will comment on this blog and offer some of your own ideas. There is never a wrong solution for joy and learning how to show it.

Read ~ Brainstorm ~ Comment

As we all know

"Speech pathologists make good things happen."

Hands have fingers, thumbs, nails, joints, skin, bones, muscles, and tendons. They are flexible and can be molded, folded, and wrapped. Use yours.

I learned early in my career that one of the most meaningful things one person can do to assure sincerity, acceptance, and understanding is through the power of touch. Not a slap. Not a high-five. A firm palm on a shoulder or forearm will do. Timing is everything and silence is paramount.

Parents grieve because dreams for their child change. The IEP process is not an easy one for the young parent and they don't even know what kind of questions to formulate. Many of them don't know what they don't know.

Here is my advice to the SLP. Share this list with other professionals within a school or private setting. The points are appropriate during an IEP or individual meetings with parents. If you do not have good communication with the child's parents, no court in the land can dictate it, and no one can fix it but you. The child's well-being depends on it.

1. Listen to the parents

Too many times, professionals are eager to depart what they know and not willing to listen to what the parent has to say.

2. Use common sense

You can only ask of the family what they are capable of giving: emotionally, financially, and intellectually. If you ask too much of the parent, they will not be able to do any of it.            

3. Discuss the child's strengths

It is much more important to know where a child's strengths than his/her weaknesses.

4. Discuss what is motivational to the child

The professional will want to use what is motivational to the child in the educational setting. Remember that the motional item may vary frequently.

5. Start the meeting with three positive statements or anecdotes about the child that   would be pleasant for the parent to hear

Every parent likes to hear positive stories about their child. There is no exception.

6. State up front any time limitations for the meeting

The IEP or meeting for a child with ASD can be long. Stating up front how much time is allotted can save frustration from both parties.

7. Ask the parent their main concern for their child

The parent's main concern, whatever it is, should become a main concern of the professional as well. It will not be the only concern but it must be addressed.

 8. Allow the parent some time to vent if need and have tissues handy

You may need to remind the parent of any time limitations if necessary and appropriate.

9. Ask the parent how their child differs from other children and put it in writing for all to see

The power of the written word is enormous and when it comes from the parent, it is more powerful. I often stand at a chalkboard and have the parent list characteristics of their child's behavior as I write them down. I do not verbally respond. I only transcribe until     they are have completed their list. They are usually dead-on. I can always state, "I've            noted . . . too."

10. ALWAYS plan time to demonstrate what you feel is the one most important strategy that the parent should be working on for carryover in the home (more strategies depending on circumstances)

Nothing takes the place of a therapy demonstration. Include the parent if possible.

This is my Top Ten List

Can YOU add some more?

"Speech pathologists make good things happen."

In the Dec. 13, 2012, Autism Spectrum across Ages and Environments Blog, A Driver in the Family with ASD, I told you about the skills a person needs in order to be a driver. I want to repeat a very important aspect before teaching these skills.

*Any professional involved in teaching driving skills to persons with autism should always get the approval of the team in order to determine if driving is realistic for this person. If driving is not a possibility, other means of transportation should be investigated in order to give the person with autism as much independence as possible. Safety is always the first consideration.

My son, Doug, with his new 2013 Chevy Cruz

Strategies for Teaching the Skills needed for Driving

• Play board games like Connect Four, Checkers, and Chess. These teach turn taking, require quick thinking responses, planning, and prediction. The adult needs to push for faster responses. If the person with ASD has a favorite game, use that but always in a turn taking model and implementing all of the language skills he/she possess.
• List vocabulary related to cars. Go over, and over the vocabulary words and definitions. Any car dealership would be happy to give you beautiful pictures of their new car models from which the student and adult can identify various parts, locations, functions.
• Use commercial or homemade maps as visual guides. Identify streets, prime locations, etc. Be sure to include concepts such as North, South, East, West, left, and right. This is a good time to predict - If you were driving on _____ St. what way would you turn to get home?
• Use Lego's or small cars, set up scenarios for stop signs, stop light, turns, four-way stops. (Our family practiced with Lego's for many weeks before our son was comfortable with four-way stops)
• Role-playing is a must to practice a variety of situations. Typical developing peers or siblings who have experience driving are beneficial.
• Discussion groups of new drivers talking about real life situations, feelings, fears, problem solving, and destinations. (A great time for social interactions)iPad applications such as: Drive & Learn and Learn to Drive. (These should be utilized by two or more people in a turn taking and discussion model)

Many people feel that persons with ASD should not be allowed to attain a driver's license. I totally disagree. People with ASD who want to drive, are capable of controlling their emotions and impulsive behaviors, and are willing to learn the necessary skills should be given the same opportunity as any other adult. Driving allows independence for both employment and pleasure. It is a responsibility that needs to be taken seriously by the entire team and one that will give the person with autism a giant boost of self-esteem.

"Speech pathologists make good things happen"

Time marches on. Growth takes place. We learn from each other. A new year is about to begin. It is time to review FIVE important things about autism that remain the same.

• Characteristics vary widely

There is a wide bridge and a big diversity in the characteristics of autism from child to child or adult to adult. All adults with autism are not Rainman. The symptoms vary widely in severity, duration, and across environments. It is important to observe social, behavior, and language skills. History and parent report are also significant components of a profile for ASD.

• Early intervention is paramount

No one can retrieve lost time. It's that simple. It's that important. When a child is referred to the SLP by another professional or parent for "weird behavior," lack of speech, or unsociable responses, listen and observe. The SLP must train him/herself in knowing and understanding what it is they are hearing and seeing. I have worked with children and their families as young as six months when their responses to their environments were not normal. Everything we do as professionals should be directed toward independence. Start now, because the sooner, the better.

• There is no cure for autism

If anyone tells you their child has been cured of autism, I would say the original diagnosis was incorrect. There is no cure for autism, however, with professional and family interventions, autism can look very different as a child matures and grows. There is no cure for many maladies and as professionals we MUST help families understand, learn, control, and accept autism as part of their lives. We MUST provide hope, strategies, knowledge, and trust. We are their SLP.

• Therapies should be interactive and cross environments

I am a huge believer in teamwork. But ~ I believe that team needs to be on the same page. The proven therapies of speech, occupational, and physical are all good individually but together they are powerful in a child's life. Again, they are good in the school and good in the home but great when they cross environments. Why is it that some schools or private therapists will NOT allow parents to observe or be part of therapy? That boggles my mind and stabs my heart. (When my son was young, I was a part of what was going on in his classroom at school, school therapy, and private therapies of all kinds. THAT propelled carryover and growth.) Believe me when I say, the more the child grows, the better YOU look ~ so share your knowledge and strategies whenever and where ever you can.

• High expectations are key

"Nobody ever rose to a low expectation." Teach the child to sit without quality therapy and he/she will learn to sit. Give the child fun, quality therapy, while sitting and he/she will LEARN HOW TO LEARN. I expect a lot from the children with whom I work. I tell them they need to "EARN" it. I ask them, "Who's the most proud of you?" (they are). Yes, I expect a lot ~ they know it ~ they give it ~ they learn ~ they are proud of themselves.

So, welcome to 2013. It always takes most of us about a month to remember to write the new year on checks or paperwork because we're used to our old ways. Nobody really likes change. Because we're SLPs, people's lives depend on our ability to change, to learn, to adapt, to give the best we can in this New Year.

As we all climb into January 2013 we need to resolve and know that we have done many great things in the past for our clients with ASD. That's not going to stop. We're just going to bring that Ladder of Success and climb higher and higher.

That's because

"Speech pathologists make good things happen."

Social skills aren't really so hard. Most children glean them during play and with appropriate guidance. No, social/pragmatic skills aren't hard at all, not unless you have ASD (as well as other mental disorders)

Social skills only . . .

• Make or break every relationship
• Determine whether a person will attain or maintain employment
• Gives one the ability to utilize his/her full and appropriate intellectual capacity
• Gives a person freedom to communicate in a typical manner
• Make the person who lacks them a target for bullies
• Give people understanding of life through humor, figurative, and abstract language
• Give people the ability to understand other people's feelings
• Determine the amount of joy, happiness or depression and isolation a person seeks
• Drive a person's goals in life to achieve fulfillment

Social Skills aren't so important after all!

Are they?

I know the Individuals with Disabilities Education Act (IDEA) has many good aspects to it and it drives our profession in educational settings. However, the phrase, "does not impact education or academics" is where I have a problem. So, I've developed my own answer, and you can use it too. I actually drew a picture for you because our kids with ASD need us.

Don't they?

If all of the reasons listed above depend on adequate social skills and people with ASD lack these skills, they definitely impact a student's educational outcome! So to justify providing speech/language services to ALL children with ASD, you now have the approval of IDEA and most certainly, ME.

"All the powers of this office," says President Obama, in his speech as I am typing this blog that includes education. So all the powers include us, as SLPs, to help people understand social mores and to be able to assist the person with ASD to control and channel themselves in society. We cannot cure autism. We cannot solve or predict all of the situations that might occur in a person's life and head them off. BUT, we can change and make the lives of those people we touch better and more sound.

Kathie's List:*

• Turn taking
• Choice
• Categorizing
• Sequencing
• Abstract language
• Figurative language
• Absurdities
• Predicting 
• Role playing
• Anxiety reduction
• Greetings and salutations
• Topic maintance
• Perseveration (reducing it)
• Friendships
• Manners
• Grooming
• Eye contact
• Focus/attention
• Appropriate laughter
• Questions
• Statements
• Strengths vs. weaknesses
• Real vs. fantasy
• Theory of Mind

Oh, could Kathie's List go on? I'm sure it could. Remember these caveats about ASD.

When you think you're done ~ you're not

When you're tired of the redundancy ~ do it again

If you're bored in therapy ~ so is the client

Teaching in one situation ~ will probably not carryover into another

Today ~ will not be like tomorrow

* (My list is not all inclusive, and I hope you will add to it. I am making a simple list because as SLPs, you know what to do to enhance social/pragmatic skills in people with ASD at all levels, ages, and across environments. This is my 107th blog for ADVANCE — I encourage you to review the past ones that are specific to the following list. I have two books on autism/ASD: Tears of Laughter ~ Tears of Pain and I Never Told My Son He Couldn't Dance, I have numerous articles in national autism magazines, webinars and information on my personal website at Kathie's World. I am also writing a new book titled Meaningful Action for parent and how to deal with social skills in the home. There is good information if you need more and my personal e-mail is kathieh2@cox.net.)

The thing I will always know and stand behind is that

"Speech pathologists make good things happen."

Return to the homepage.

As an SLP you have the skills to teach children and adults on all levels of the autism spectrum social strategies they will need throughout their lives.

As an SLP you have the responsibility to speak up at an IEP in the school or any setting when you hear that "social skills do not impact education" and state all the reasons why they do.

As an SLP you must convince parents/caregivers/professionals the importance of all social aspects of communication AND share strategies through demonstrations/handouts/conversations/any way you can.

In light of the tragic, horrific events that took place in Newtown, CT on Friday, December 14, 2012, I write this blog with a heavy and concerned heart; a follow-up to my blog, of 12-17-12, School Shooting and Asperger's.

The murderer of twenty-seven souls (including his mother's) is reported to have been diagnosed with Asperger's syndrome. He was intellectually gifted and I do not know whether he received speech/language therapy at any time during his education, either through public or private means. It must also be stated that autism/ASD can co-exist with any other disorder, which this young man most likely had. There has been a lot of chatter from the news media about Asperger's and a propensity toward violence. In my mind, I don't want any of that to be true, but in my heart I believe it can, especially when mixed with other emotional and psychological disorders. Now, let me tell you why.

(code for the following: Asperger's + = Asperger's and any other mental disorder)

• People who are quirky, different, weird, socially isolated are BULLIED (I wrote four blogs on bullying July 19, 2012, July 26, 2012, August 2, 2012 and August 9, 2012)
• When people are bullied they become defeated and depressed
• People who are isolated build up rage with no place to release it

On the Shooting

• Everyday Heroes

• School Shooting & Asperger's

• Return to the Home Page

• People who are isolated devalue themselves and have a low self-esteem
• People with Asperger's + often explode with rage for little or no apparent reason
• People with Asperger's + are perseverative
• People with on any level of ASD experience high anxiety (blog of 1-12-12)
• People with Asperger's + are smart but cannot always express themselves
• People with Asperger's + have difficulty forming appropriate relationships
• People with Asperger's + do not have empathy or experience feelings in the same manner as typical developing people
• People with Asperger's + do not formulate appropriate questions
• People who are isolated often watch television, movies, play video games to an excess and many of them today are very violent
• People with Asperger's + do not generalize information
• People with Asperger's + have difficulty with Theory of Mind (knowing what another person is thinking and feeling)
• People with Asperger's + have difficulty with abstract language, inferences, and figurative language

People with Asperger's test in the normal to above normal range intellectually. Thus, they do not often qualify for speech/language services BECAUSE social language does "not impact education."  BET ME!

The SLP is paramount in giving speech/language services to people on all levels of the autism spectrum for expressive, receptive, and pragmatic (social) language disorders. When we are passionate about doing so, we will be compassionate, and the child, adult, and family will know they are being cared for. All of society will be a better and hopefully, a safer place because of the passion for what we do and KNOW that it is right.

Timothy Kowalski, M.A., CCC-SLP, wrote a great post about mass murderer Adam Lanza in which Tim states:

My hypothesis is that this young man was never treated properly and never learned how to deal with frustrations that all of us experience. IF this is the case, it only serves to highlight the importance of why social skill instruction is critically important when working with these individuals. If we only focus on "academic needs" and not address the real issues that isolate these individuals, my fear is that more of these events will continue. 

Is it possible that this event was a warped version of the Star Wars scene in which Luke Skywalker went to the "dark side" and slaughtered the Jedi youngsters? We'll never know but it would be interesting to see if he was a hard core Star Wars guy.

My heart goes out to those touched by this tragedy - and that includes my clients as well. I'm already receiving inquiries from parents as to how to handle this because their kids are asking if they will do that too. 

If you hear "it doesn't impact him academically," now is the time to rebut that statement.

Next week I will be back to post what you need to do in therapy in order to promote social learning language skills. Yes, they DO support education and life skills.

 Count on it, because with all my heart, I know that

"Speech pathologists make good things happen."