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Episode Summary

When it comes to developmental milestones for children with autism, engaging the “theory of mind” is all about that first critical step towards fostering perception. Kathy O’Brien, our guest on this episode of All About Kids, explains why understanding inferences and differentiating human visual cues is a foundational portal for long-term communication. With her powerhouse trio of advanced studies in psychology, special education and communications sciences, Kathy brings to her work a clear road map for creating meaningful engagement among children with autism. The families she works with learn about the importance of evolving a strong sense of “joint attention” and what it looks like to cultivate intuition and inferences as a basis for deepening human connection and, ultimately, relational behaviors and decisions. Join Host Zach Grossfeld in learning why eye contact is important, how role playing builds emotional agency and what families can do to support ongoing development outside of structured services. You’ll also get a glimpse into some of the biggest myths about autism and how the games we play can teach communication, resiliency and collaboration!

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Episode Notes

  1. Recalling the experiences that drew Kathy to children with autism.
    1. About an early job at an adult group home that inspired an interest in helping bridge communication and connection.
    2. “For me communication is just a way to connect with others either verbally or non-verbally. So I taught (an early client) a sign for ‘eat’ and that was it. I’ve been hooked ever since. It was like a magical thing for me.” (Kathy)
    3. How  breaking through and giving people with autism tools empowers them to take agency and an ability to get their needs met.
  2. Refining her mission: What sharpened Kathy’s focus on speech development.
    1. At work using her newly minted advanced special ed. degree, the differences in communication styles and abilities among children were quickly evident.
    2. Kathy returned to school for a second master’s – this time in communications sciences – launching her as a speech pathologist and communication expert.
    3. Defining ABA: How Applied Behavior Analysis shapes behaviors and learned responses to optimize communications.
    4. Defining Apraxia: A motor speech disorder that inhibits the sequencing of sounds/syllables and language development.
  3. Taking a closer look at one of Kathy’s core passions as an educator.
    1. Why “theory of mind” is so critical to honoring the feelings, perceptions and intentions that reside in us all – no matter our communication style.
    2. How “theory of mind” is critical to making inferences and differentiating human visual cues based on general or specific perceptions.
    3. Click here to see the animation used by Heider and Simmel in their groundbreaking 1944 apparent behavior experiment. What you see says a lot!
    4. Neurotypical people assign feelings, narratives and beliefs to symbols where people with autism typically do not decipher meaning.
  4. Are you projecting? Understanding what we see in animals and why.
    1. How we tend to bring ourselves to the ways in which we see animals.
    2. Emojis are anthropomorphic, too. Well, sort of!
    3. Why children with autism have difficulty picking up on visual cues that associate motions with shapes/expressions.
    4. “Neurotypical people are just programmed (to see narratives), subconsciously and instantaneously. We probably don’t really stop and think about it.” (Kathy)
  5. How “joint attention” is foundational to social relationships and intuition.
    1. Children with autism may be slower to draw spontaneous inferences initially but can be brought along and helped to develop recognition over time.
    2. Why “joint attention” needs to be firmly in place as a precursor to language.
    3. “In order for a child to learn words they need to be engaged with caretakers and their environment. A lot of children learn words not by direct instruction but experientially.” (Kathy)
    4. What “joint attention” typically looks like:
      1. A newborn baby fixates on eyes and mouths.
      2. At several months old, babies may engage in “dyadic joint attention,” mirroring facial expressions or behaviors.
      3. At eight or nine months old, babies may develop social referencing and begin interpreting facial cues from caregivers.
      4. After nine months, triatic attention develops, in which children start to process visual cues and feedback from multiple reference points.
      5. By around a year old, a child may start to point to things with the assumption that what they perceive others perceive as well.
    5. “Without face regard or really looking at the face or eyes and that non-verbal communication, a child might have difficulty understanding more about the world.” (Kathy)
  6. What’s the big deal about eye contact?
    1. Connecting through the eyes is a deliberate attempt to gather information about others and their intentions.
    2. Inferences and choices are based on reading non-verbal behaviors – which are the basis for a vast majority of human communication.
    3. Comedy, with its exaggerated affect, can be a great tool for focusing attention and helping children make inferences.
    4. “A lot of (whether people with autism ‘get’ comedy) has to do with auditory processing, multi-meaning words and understanding … so much is about social nuances.” (Kathy)
  7. Calling out the biggest myths about autism:
    1. That all people with autism are alike or have the same deficits.
    2. That having autism in some way is the defining individual characteristic.
    3. “Just because someone is diagnosed with autism doesn’t really mean you know what that person is about (because) thousands of other things define their personalities.” (Zach)
  8. The role of play in developing “theory of mind” and “joint attention.”
    1. Games can be an important point of entry for connecting with children who have autism.
    2. Finding a way to engage children is the primary thing – whatever it takes to spark light in their eyes and a joyful interaction.
    3. Look for ways to build on a current sensory motor scheme, perhaps with ideas from an occupational therapist.
    4. “It’s mostly about getting into the child’s world. It’s just that connectedness that is the most important thing.” (Kathy)
    5. “You’re finding what they find interesting … and tailoring a game around that to keep their attention.” (Zach)
  9. Taking a look at children’s typical “stages of play.”
    1. Initially it can look like cause and effect or symbolic play.
    2. Higher levels are focused on representational play based on children’s experiences and knowledge of the world.
    3. Later levels of development might represent common experiences or somewhat less typical experiences.
    4. Fantasy tends to form the basis of more advanced play – which can open doors to wondering about things like desire, motivation, intention and outcome.
  10. Advice for parents who want to help their children with autism develop outside of structured services:
    1. Talk about characters in books that come home from school or are around the house – their traits, behaviors, situation-based emotions and what might happen to them as a result.
    2. Consider incorporating a “mood meter” as a way to enhance a child’s ability to identify and express emotions in stories or among people in their lives.
    3. Help build resiliency by exploring how characters come back from experiencing emotions like sadness or angry and how to self-regulate.
    4. “One of the best ways we can develop resiliency in our children is teaching them regulation and coping skills. And we can do that through books.” (Kathy)
  11. About the potential impacts of social media on childhood development.
    1. If we’re spending less time looking at each other and interacting face to face, it likely follows that some non-cues may be harder to learn and understand.
    2. It’s important to make time for play and engagement with three-dimensional humans who often use non-verbal and nuanced means of communication.
    3. Social and conversational skills are developed through real-life interaction.
    4. Collaboration is another important tool developed through real engagement.
    5. Perception skills are key to interactive play and collaboration.
    6. “Children … understand that perception leads to knowing. Someone who looks inside a box will know what’s in it, but someone who cannot see what’s inside the box will not know.” (from one of Kathy’s presentations)
  12. How perception impacts development for children with autism:
    1. Deception is harder to identify.
    2. False beliefs may be more difficult to highlight and explain.
    3. About Fibber, a family card game that can help kids “get” the concept of lying and learn to discern for themselves what is really true.
    4. “(Determining who’s lying) is a survival skill … but there’s a way to do it that is very child-sensitive with a lot of games and stories.” (Kathy)

About All About Kids:

AAK, the leading provider of children’s therapeutic and educational skills in New York. Their team of experts offer diagnostic evaluations as well as direct and consultative behavioral intervention services to children with Autism Spectrum Disorders. After comprehensive assessment, each child has a portfolio or program book designed specifically to meet his or her individualized needs. The quality of our ABA services are closely monitored through program and field supervision as well as ongoing consultation by BCBA’s/BCaBA’s, and Experienced Team Leaders. 

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