Welcoming an Autistic Child

Nurseries and preschools today welcome children with handicaps, among them some who are called "autistic."

 

Read also: Special on Autism

1. What does the autistic child look like? Who is this child?

Often, he is a beautiful child. Yet soon we discover something is wrong. He isolates himself, stays in a corner, rocks back and forth.
Indifferent, he does not turn his head when called, when his name is spoken. And yet he hears the smallest sound and is fascinated by music. He avoids our gaze and seems to look past us, with an empty stare like that of the blind. Yet he sees very well and can pick up, without hesitation, a tiny pebble, find his favorite object without appearing to search for it. He grabs toys without looking at them, does not follow them with his eyes; if they fall, he does not search for them. He is drawn to moving toys, to round objects like balls and tops, and loves to spin things endlessly in his hands. He has no anticipatory gestures (does not reach out his arms to be held). Any change fills him with panic, he cries without reason. Sometimes he becomes aggressive or self-injurious (scratching or hitting himself). Our presence and our efforts to engage him leave him indifferent or even trigger fear or panic.

You can acclimate him by holding him on your lap; we are then slightly behind him. If even this gesture is "too much" for him, do not speak to him in that moment, but only hum softly.

You can acclimate him by holding him on your lap; we are then slightly behind him. If even this gesture is "too much" for him, do not speak to him in that moment, but only hum softly.

We soon understand that this child inhabits another world, but we also understand that it is a world of great suffering and loneliness. Above all, let us not forget that he understands far more than his behavior might suggest.

2. What happens in us?

To welcome a handicapped child is to welcome a different child. To welcome an autistic child is to welcome a child completely foreign to our world, and this raises many questions in us.
Why does this child seem to be in such profound indifference, such great suffering? Why am I helpless to aid him? Why does he not seem to notice that I love him, that I wish to ease his pain? Why does he reject expressions of tenderness? Why is he aggressive with me? Why does he see me as someone dangerous or harmful?
At this point, everything is called into question: our maternal gestures, our displays of affection. All the educational habits we use with other children seem useless and meaningless when applied to him. Every moment of the day, no matter how ordinary, sparks conflict.

We must always negotiate, never sure if he is asking for something or what. He makes no requests except to be left alone. But is that the answer? It is a disheartening situation in which we feel lost, unable to offer him any real help. And so doubt follows doubt. We are tempted to think that we are not the parents, caregivers, or teachers this child needs, and only with a sense of uncertainty do we begin to truly connect with him. Then the questions become more fundamental. What can we do for him? Is it right to enroll him in nursery or preschool? What resources can we deploy to help the child and his family? First, we must know that these doubts are painful, but they may help us find the path to reach him.

The autistic child cannot settle into an embrace: he is either a limp doll or a wooden stick.

The autistic child cannot settle into an embrace: he is either a limp doll or a wooden stick.

This child struggles with disorders of relationship and communication; everything we attempt to help him communicate and relate will always benefit him, even if the results are minimal. Welcoming him also relieves the family, especially the mother, allowing her to recover—for this child is exhausting. For the family, it also offers contact and support.
We will speak more of this later. Finally, welcoming him means offering the child an environment with other children, where he can attempt his first steps toward communication and social life.

So, how do we begin?

We are torn between wanting to engage him, to show him our interest—which may frighten him—and the thought that it is better to leave him in his isolation where he seems content. We must try to reconcile the two.

There are two essential types of intervention.

1. Help him establish communication. This will require great effort from him; so it is wise to encourage him but give him time to rest in his own world.
2. Help him grow familiar with those around him, to make contact with him so he fears us less. For this we have at our disposal:
   
   
   1. words that humanize
   2. gestures
   3. the key moments of the day (meals, play, sleep).

a) Words that humanize:
This child is not deaf; do not shout at him, but speak slowly and naturally. Sentences must be short and simple.
Every interaction with him should be narrated, but without flooding him with words.
When you notice the child has become interested in something on his own, do not intervene by commenting on his action. Better to talk to yourself, as if discovering the same point of interest (for example, a shaft of sunlight, a top). When we find ourselves in an unexpected situation, our reflex is to say NO, especially if we fear danger. With an autistic child, avoid negative sentences. This does not mean accepting everything; it means finding another way to express it. For example, if what he asks is not possible: "I see you want a snack; I think you'll need to wait a bit."

Often, he is a beautiful child. Yet soon we discover something is wrong.

Often, he is a beautiful child. Yet soon we discover something is wrong.

The autistic child expresses his wish by acting it out; so it is vital not to begin with NO—"Don't touch," "It is not time for..." Your intervention in this case would be like refusing to hear his words.
Instead, put into words what he is trying to say with his actions. (For example: "I see you want to climb on the table, you want to get the scissors.") Only then should you intervene to prevent danger if there is one; otherwise, allow the child to make his discoveries in his own unusual way (for instance, picking a daisy and eating it).
Of course, avoid discussing his difficulties in his presence. If you need to share information with parents, it is best to include him in the conversation by speaking to him as a witness. (For example: "Isabella did not eat today, and looking at the child: 'I think you were not hungry.')"

b) Gestures that accompany
The autistic child tolerates overt displays of affection poorly and reacts badly to sudden changes in demeanor. At first, before he has "gotten used to" you, avoid picking him up or kissing him. You can acclimate him by holding him on your lap; we are then slightly behind him. If even this gesture is "too much" for him, do not speak to him in that moment, but only hum softly. He must not feel trapped in your arms, yet the embrace must be firm enough to feel reassuring; the autistic child cannot settle into an embrace—he is either a limp doll or a wooden stick! To encourage him (for meals, play), it is good to sit beside him, since he has difficulty tolerating direct eye contact and this spares him an additional strain. Gestures will be especially important with younger children.
All opportunities for toileting, dressing, and changing should be treated as precious moments for communication work. We do not fully understand how they perceive their bodies, and these are chances to help him become conscious of his body in a pleasurable way: here too, you must speak and narrate what you are doing. Avoid sudden gestures, even if made to prevent danger. Precede them by showing the child the right gesture to make (explanation and prevention).

Indifferent: he does not turn his head when called

Indifferent: he does not turn his head when called

c) Sleep, meals, and play
Sleep and eating are often sources of conflict and difficulty in an autistic child's day. He struggles greatly to pass from wakefulness to sleep, and he is highly selective about which foods he will consume. Once again, careful observation will reveal the approach that suits him best and allows us to help him. Remember what matters most in these moments: that he finds sleep, that he eats. Educational standards come second. So be tolerant of his "rituals" and "habits." (For example: if he does not want to remove his clothes to sleep, let him. When he grows more comfortable falling asleep normally, you can suggest removing at least his socks.) The same applies to meals. Accept his preferences, even if they are exclusive, and introduce new foods by leaving them within reach without offering them. If he makes an attempt toward these foods, make no comment. For the autistic child, toys have little meaning. What matters is watching you play and gradually inviting him to join. A good game to start with is rolling a ball toward him. Accept too that he may use toys in ways the maker never intended. He may enjoy balancing objects but not building. Abstract representations like dolls and stuffed animals mean little to him. As play, it helps to make the environment familiar to him: let him play freely with earth, pebbles, water, and so on. Singing and music are invaluable aids. He is very responsive to them. You can use songs to convey some of your messages. When the child is nervous, music often calms him. But it should not become a way for him to isolate further.
Finally, do not tidy up without him present. Finding objects where he left them is his thread, like the pebbles in the story of Hansel and Gretel.

Severe behavioral problems

Aggression and anger, whether directed at us or at himself, are not the autistic child's desire to cause harm; they are rather a way of breaking into our world. Try to discover what triggers these fits of rage and aggression: often you can prevent them; yet many of these behaviors will remain puzzling.

It helps to make the environment familiar through play: let him play with earth, pebbles, water

It helps to make the environment familiar through play: let him play with earth, pebbles, water

If the child is in a rage, isolate him in a calm place and stay with him. You may need to hold him to keep him from hurting himself; in that case, sing softly. When the crisis passes, even if he is very young, explain what you have tried to do: "You were very angry, I held you because I do not want you to get hurt."
Remember too that the autistic child has no sense of danger and that the experience of pain does not stop him. If he gets burned, it will not prevent him from doing it again.
Know also that we cannot educate him with rewards and punishments; they have no meaning for him.

In conclusion, the autistic child will be helped more by who we are than by what we do: we must be a CAREFUL OBSERVER, CALM, SERENE, TOLERANT, CONSISTENT, FIRM, TENDER, CONFIDENT IN HIM AND IN HIS BECOMING.

No method will succeed without these personal qualities.

- Beatrice Frank, 1990
(Condensed from "Sesame" no. 88)