Counting Activity--Fighting Fires


My students loved this counting activity.  As we were preparing for the fire department to come to our school for an assembly we all practiced our firefighter skills.

Thanks to the father of one of my past students and the Salt Lake Fire Department, each one of my students (actually every student in our school) had a fire hat.  I made "fire extinguishers" out of empty water bottles covered in red paper, and I printed out "fires" and hung them throughout the hallway.  Each paper had a different number of flames on it that the kids would have to count.

We did this activity two different days.  The first day I had cards printed out with written numerals.  The kids would be at the "fire station" which was a designated place in the hall, and I would show them the number.  They would then have to go find the corresponding fire and put it out with their "fire extinguishers."  

The second time we did it, I had cards with flames on it, then the kids had to count those flames and find the matching flames in the hall.  That way they had to count more than once.  

Here are a few reasons why I loved this activity
  • It was engaging, the kids loved it
  • Math skills
    • We worked on counting with one to one correspondence
    • We worked on matching objects with written numerals
  • Fine Motor
    • Squeezing the spray bottles
  • Thematic Play
    • The kids were pretending they were fire fighters
  • Teamwork
    • When the kids would find the correct fire, they would call out to the others
  • Turn taking
    • The kids would take turns "spraying" the fire

Show And Tell: Lights Go On

This is just a simple little song to help with cause and effect, and the concepts of on and off.  I like to use the touch lights that you can usually get at the dollar store.  With those you can work on some motor skills as well, like hand strength, bringing hands to midline, thumb opposition, bilateral coordination, etc.

You can use all different kinds of lights when singing this little song, including lamps, flashlights, night lights, christmas lights, lava lamps, bedroom lights, etc.

You could really change this song to introduce a lot of opposite concepts.

Here are the words I made up for the on and off concept:

Lights go on and lights go off
Lights go on
Lights go off
Lights go on and lights go off
On and Off

Joy Mano
Utah PLAY Project Home Consultant
Early Intervention for Kids with Autism




photo credit: DELLipo™ via photopin cc

Behavior and Positive Reinforcement

In my last post I talked about the ABCs of Behavior, which is a great way to collect data on behaviors that may be a concern.  But, what do you do with that data?  First, you look for patterns.

Let's say that the pattern you found was in the 'CONSEQUENCES' column.  Every time that Sara screamed, she would receive attention.  One thing to remember is that attention is attention whether it's positive or negative attention.

Now comes the tricky part, changing the behavior.  I think that an important part of this is first recognizing what you (the adult) needs to change in your own behavior before attempting to change the child's behavior.

When it comes to 'attention', how we react to behaviors becomes very important.  We may need to change how we react to certain situations, and we may need to give more attention whenever we see positive behaviors displayed by a child.  For every correction or negative comment that is given, a child should receive at least 4 positive comments/interactions.

Here are some ideas to help you as you make a plan (I'm sure there's many more ideas that many of you can come up with too)
  • Increase your positive reinforcement during times when the child is acting appropriately (not just following a "tantrum", but throughout the day)
  • Plan times to spend one on one to play, especially if you know that your child is seeking attention.
  • When a child is having a "tantrum" compliment the other kids who are acting appropriately, and be specific about what you like that they are doing.  Then when the child having a hard time does any of those things, immediately compliment him/her, reinforcing the behaviors you do like.  If there are no other kids around, it's fine to compliment the stuffed bear sitting in the chair for sitting quietly.
  • Teach a replacement behavior.  What do you want the child to do instead of screaming?  Help walk them through the steps, then give positive reinforcement (or natural consequences of giving them what they want, if appropriate) when they use the replacement behavior.
  • Ignore the inappropriate behavior (if it's safe), but follow up with positive reinforcement the second they are doing anything appropriate.  If they are screaming, compliment them the second they stop.  Be specific in your compliments though.  Instead of "good job" say "I like how you have a quiet voice and are using your words to tell me what you want."
Something to remember is that there is something called an extinction burst which means that often times the behavior will get worst before it gets better.  Sometimes the limits have to be tried before the child realizes it's not working.  So don't give up, these things take time.  Consistency is the key, and some of the most important times are not when the child is in the middle of the crisis cycle, but when they are calm and happy.  Positive reinforcement can be pretty powerful.

Joy Mano
Utah PLAY Project Home Consultant
Early Intervention for Children with Autism

photo credit: Sebastian Anthony via photopin cc

ABC's of Behavior


I first learned about the ABC's of Behavior when I was a teenager working at a group home for people with developmental disabilities.  The women I worked with had varying ability levels, and a few of them had tendencies towards aggression.  Some days it was very obvious why they were upset, but other times it could be a puzzle.

These ABC's have come to be very important throughout my career of working in various environments, whether I was working in group homes, summer camps, schools, care centers, workshops, or homes.

So, what are the ABC's of Behavior?

A=Antecedent
B=Behavior
C=Consequence

Another important thing to consider are Setting Events, which I wrote about in another post.

If you understand these ABC's, you may be able to gain valuable information that may help reduce some behavioral outbursts.

Antecedent:  What happened right before the behavior.
Behavior:  What did the behavior look like, this should be specific rather than general.  Instead of saying "she had a tantrum", you should describe it "she screamed for 5 minutes."
Consequence: What happened right after the behavior.  This is not necessarily referring to how the child was disciplined.  It is whatever happened directly following the behavior (i.e., peers in the class laughed, the teacher stopped and asked the student to stop, the student was escorted out of the class, etc.)

Using this ABC form can help you start to recognize patterns in an individual's behaviors.  If you are looking to reduce the frequency of a behavior, you will want to be specific on which behavior you are tracking, and be as specific as possible when filling out the form so you have lots of information.

You will want to track the behavior at least 1-2 weeks, and you should take data every time that behavior occurs.  You can track multiple behaviors at a time, but to begin, I would suggest tracking the behavior that is of greatest concern.

Once you have some data, and have some ideas of why the behavior you are tracking is occurring, you can start making a plan.  Check out my next post, as I will discuss some ideas to help you with this.

Joy Mano
Utah PLAY Project Home Consultant
Early Intervention Services For Children With Autism

Show And Tell: Hog Wild Poppers

My sister, who is a Pediatric Occupational Therapist, called me one day to tell me about these awesome toys she just got.  They sounded like fun, so I got on amazon, and bought a couple.  They're called Hog Wild Poppers.

Clear Horizons Academy, the school I am going to start teaching at in Fall 2013, asked if I would come and do a pre-writing activity with some of the kids so that they could see my teaching style.  I decided to use the popper toys as a fun activity.

To get ready for the activity, I made some shapes and put them on manila folders.  You could do letters, numbers, word recognition, nouns, verbs, anything you're working on with receptive language really.  If you fold the back part of the folder up, it makes for a nice little stand.

I showed the kids the folders, and I had them trace the shapes with their fingers.  Then I set them up as targets.  I would tell them what shapes to hit, and they would try to hit them with the poppers.  Some kids needed the activity adapted more than others, but it's easy to do.

There's so many different activities you could do with these, and I think it would be fun for kids that are older than preschool as well.

So here are just some of the reasons why these toys are so awesome, and how they can help with child development.

  • First, who doesn't love shooting balls across the room.  They're engaging and fun, and can keep the kids attention.
  • Color/Shape identification
  • Making choices-I had them choose which color ball they wanted, and which animal they wanted to use
  • Taking Turns-We took turns shooting the balls
  • Fine Motor Strength
    • Squeezing the poppers to strengthen hands
    • Manipulating small objects (balls) 
  • Thumb Opposition
    • Squeezing the poppers
  • Crossing midline
    • Placing objects of the opposite side of the body for them to reach for (some kids had a hard time crossing midline, so I would purposely do a little playful obstruction and make them reach a couple times across midline before I would give them the ball, especially if they would switch hands when I crossed midline)
    • Tracing large shapes
  • Pinser Grasp
    • Picking up the small balls and placing them in the poppers
  • Finger Isolation
    • Tracing shapes with their pointer finger
    • Using one finger to push the ball in place
  • Eye-hand coordination
    • Hitting a target with the ball using the poppers
  • Bilateral Coordination
    • Squeezing the poppers with both hands
    • Holding the popper with one hand while putting the ball in with the other
  • Upper Body Strength
    • Laying on their tummies while playing the game
  • Motor Sequencing
    • Following the sequence of events to hit the targets
      • Getting the ball
      • Putting it in the popper
      • Aiming at a target
      • Squeezing the animal to shoot the popper
Some warnings:  
  • This toy is not meant for kids under 3, it has small parts.  
  • Some kids will look at the toy while squeezing it, it shoots pretty hard, so you'll want to be careful of that.  Especially for kids who don't quite understand cause and effect.
Here's a list of some of the different poppers I found on Amazon.  Hope you have fun!
Utah PLAY Project Home Consultant
Early Childhood Services for Kids With Autism

Creating A Summer Picture Schedule For Your Child With Autism


I can't believe it's June!  The pool is open, kids are getting out of school, and it's time for summer fun.

Most kids seem to love summer, however a lot of kids with special needs have a difficult time during the summer months.  Some of this can be attributed to the fact that their schedule is suddenly thrown out of whack.  They may not understand why the bus stopped picking them up and why suddenly no one is doing what they're supposed to be doing.  They may not understand why those teachers that they see every day and they thought loved them have suddenly disappeared out of their lives.  There's a lot that we just expect our kids to deal with.

I had one student that I found out when we would have school breaks (I was on a year-round schedule), he would sleep with his backpack.  I also found out that at the end of the year and it was summer break he would sleep with a picture of me.  The funny thing is that it was his "no school" sign, so it was a picture of me with an X through it.  The thing that his mom and I loved about this was that he was communicating to us that he loved school.  He was non-verbal, and had very little communication.

Some (not all) kids with autism thrive on having a routine.  Behavior problems may decrease, they may be able to learn better, and a lot of times they appear to be happier.  This can be a good thing because we (the adults) can easily help with that.  At times this can also be a difficult thing if flexibility is not taught and used during these routines.

There are different ways to establish a routine.  One way is through picture schedules.  With pictures, a child is able to predict what is going to happen during their day.  They don't have to be so specific and every minute doesn't have to be planned out, but having some general idea of the day can help immensely.  If your child is at a reading level, doing a picture schedule left to right gives good left to right orientation practice.  Going from top to bottom is another way to do it, and is easier for some kids.

The order that you do things is not important, actually I would encourage you to mix things up every once in a while because it can help with the flexibility.  The thing that is routine and stays the same for them is that they know where the schedule is, and they know that it will show what is going to happen. When you go on outings, you don't necessarily have to have where you are going on the schedule, but just that you're going.  However, it would be good to have a routine built in of explaining where you are going whether it's with a social story, or just explaining it.  This way you can plan new activities without having to create new pictures all the time.  You can also add unexpected events into the schedule this way.

Here is a sample schedule,  you may want less pictures or more, it's really up to you  (I just got a bunch of pictures off of google images)  The best placement for a schedule is at eye level for the child and somewhere that they can go look at it independently when they want to:
Breakfast
Get Dressed
Read


Play

Lunch
Outing
TV Time
Play Outside
Dinner
Family Activity
Get dressed for bed

Brush Teeth
Go To Sleep
Joy Mano
Utah PLAY Project Home Consultant
Early Intervention Services for Kids With Autism

An Amazing Utah School For Kids With Autism


Wow, I did not do well at blogging in May!  Luckily, it's a new month, and I am ready to go.  It's been an interesting month for me, full of change, but exciting changes.  One of those changes will take place in August, but it was this month that I had to make that decision.

At the beginning of the month I was contacted by Clear Horizons Academy and I was asked if I would be interested in coming to their school to help create a preschool program.  Clear Horizons is a private school in Utah County for kids with autism.  They serve all ages, and they are continually growing each year.  I was flattered by this invitation.

It wasn't as easy a decision as it seems like it should have been, partly because it's just another big life change for me and would require some sacrifices in other areas of my life.  Another factor for me was that I don't live in Utah County.  All in all though, I feel like I will be sacrificing very little for a big opportunity in the end.  For years I have wanted to start my own school, and that's still in the works, but I think this opportunity to work in a private school and to help create something I love will help prepare me for future endeavors.  The other thing about Clear Horizons is that they are the only school in Utah that I know of who's foundation is based on DIR/Floortime, which is what PLAY Project is based on.

So for any of you families who are looking for a preschool program for your little ones with autism, come check out Clear Horizons!

I am really excited for this new adventure.  Because of time, it will force me to limit my private clients, however I have some ideas formulating.  I'm hoping to be able to offer some group therapy sessions with families after school, and some parenting classes as well.  Clear Horizons is great, and they are willing to allow me to rent out space in their incredible building.  They built this building just last year, and it was specifically made for kids with autism in mind.  It has a specialized playground, a sensory room, classrooms with swings, and lots of natural light.  I love it.

I'm excited for new opportunities.

Sensory Friendly Concert

A couple weeks ago I had the opportunity to go to lunch with Jaycie Voorhees.  She's a music therapist in Utah.  She is so great, and I am so excited for what she is doing in our community.  We're hoping that we'll be able to do some work together in the future :)

She's putting on a Sensory Friendly Concert next week.  Everyone is invited.  It sounds like a lot of fun with great entertainment and it will be interactive for the kiddos.  Bring the whole family, and help spread the word!  Jaycie is hoping that this will be something they can start doing on a regular basis if there is enough interest.

Embracing Autism


This weekend I was talking with a good friend of mine (Melissa), and she told me this awesome story.  I wanted to share.

Last week at school, Melissa's 10 year old cousin overheard a group of kids making fun of another kid.  The kid that they were making fun of has Autism.  So this 10 year old boy went over to the other kids, made them line up and started to give them a lecture.  He basically told them that just because people are different doesn't mean that we should treat them differently.  Everyone deserves to be treated well.

What a kid!

The story doesn't stop there.  Melissa's 10 year old cousin was told that he could only invite a handful of kids to his birthday party this year since they were having it at a place where you pay per person.  When he went home that day, he told his mom that there was a kid in his class that he wanted to invite because he never gets invited to parties since the other kids think he's weird.  He told his mom "Mom, he's not weird, he's just autistic."  He worried that this boy might not be able to come to the party because his parents always attend the field trips at school to help him, so they made a special invitation to give to him at school.  There was an invitation for the kid, and a note to the mom telling her that they would really like her son to come to the birthday party, but they understood that he may want her to stay and that she is more than welcome to stay at the party as well.

What a family!

I feel like this is one of those moments where you would be so happy as a parent...on both sides of the story.  I hope that Melissa's cousin realizes that he is an inspiration, and that an attitude like that can literally change the world.  As he goes throughout his life, he will continue to have a big impact on others around him, and will teach acceptance of differences through his words and his example.  He will be a hero to many :)

To his parents, I want to say thank you for raising your son in a way that he would be able to make these beautiful decisions on his own without worrying about who he's going to impress or make upset.  That is true integrity, and it's a difficult thing to instill in others.

Joy Mano
Utah PLAY Project Home Consultant
Early Intervention for Children with Autism

 photo credit: susivinh via photopin cc

Disneyland!


Sorry, I haven't had a post for a week.  I went out of town for a week, and failed to have posts ready before I left.

So I just spent a week in California with beautiful weather, and a lot of time with Mickey and Goofy :)  I am lucky and I have the best family ever.  I got to spend a week with my entire family, and it was so much fun.  My nieces and nephews are the perfect ages for Disneyland, so we had a blast.

Disneyland was always our family vacation growing up, which I didn't mind.  However, as soon as I graduated High School, I did learn that there are a lot of amazing places out there to travel to.  I love traveling.

Disneyland or Disney World with my nieces and nephews is so much fun though.  My favorite ride has always been Peter Pan, probably because I always have wished that I could fly :)  Now I really like the new Cars ride and also the Toy Story ride.

This year we went to the World of Colors for the first time which is a huge water show, and I have to say it was pretty amazing.  I also saw the fireworks one night and Fantasmic.  We did it all.

One special experience I had was when I was getting off a ride with my 10 year old niece and there were some people that were waiting to get on, and they did not have to wait in line.  She asked me what they were doing and why they didn't have to go through the line.  They had some autism awareness shirts on, so I had the opportunity to explain to her how awesome Disney is (although I have heard they may be changing the program due to people taking advantage of the program without having a disability, which is really sad that people do that.)

I explained a little to her about how some people have special needs and have much more difficult lives than we do, so what Disney does is they allow them to be able to have the best time they can at the park with their families without having to worry about standing in line.  I also explained that for some families if they had to stand in line, they would never have the opportunity to go to Disneyland because it would be too hard.

I love when I get little opportunities to explain things like this to the kids in my life (and the adults too.)

Doctors Office Intervention for Kids With Autism


We all know that visits to the doctors office can be difficult, I addressed some of those reasons in my post about sensory overload and the doctor's office.  Today I want to share an experience that one of my student's parents told me about their visit to the doctor.  We'll call this child John.

John hated going to the doctor, it just wasn't a pleasant experience for him or anyone that went with him.  John's mom said that usually both of them would leave the doctor's office crying, it was just a horrible experience.  That changed.

Here's what they changed at their doctor's office.

  • First, John's doctor sent him a story which included pictures of the doctor's office and a play by play story of what would be happening.  It also included pictures of the nurses and the doctor that he would be visiting.  John's mom read this story with him several times before his visit to the doctor.
  • Next, John's mom was allowed to check in as they were driving to the doctor's office.
  • Since they already checked in, when they arrived to the doctor's office, there was no waiting.  They immediately took John back.
  • Prior to the visit, John's mom filled out a questionnaire that included what John's high interest was.  John's favorite toys were Toy Story toys.
  • The nurses used Buzz and Woody to help John with transitions.
  • John used to get very upset when he had to be weighed, but this time the nurse showed John how Woody was going to be weighed first.  She narrated what was going on, so when it was John's turn, he was excited to get weighed and did it without a problem.
  • Once John got to the room he was assigned to, there was no waiting!
  • John's nurses and doctor basically used PLAY to make John feel comfortable, and to help him to follow directions.  John's mom said it was amazing.
  • The best part was that both John and his mom were able to leave the doctor's office without a tear :)
I was so impressed with this doctor, and I wish that more people could implement some of these simple techniques in order to help more children have successful experiences out in the community.

Joy Mano
Utah PLAY Project Home Consultant
Early Intervention Services for Children with Autism

Show And Tell -- Tip Tip Dig Dig

Happy Show And Tell Day!

First off, I love Emma Garcia's books.  They're so much fun.  One of the reasons I fell in love with her books is because my students loved them so much.  Many of my students who didn't usually participate in circle time would imitate all the actions for this book.  It's so simple, it has good repetitive lines the kids could repeat, and nice action words that could be acted out.

A lot of kids with autism love cars or trucks, so this Tip Tip Dig Dig is kind of perfect as far as an attention getter.  If you are working on imitation skills, this book is motivating.  If you are working on actions words, it's also a good one.

A couple other Emma Garcia books that I love are Toot Toot Beep Beep, and Tap Tap Bang Bang.  Check them out!

Joy Mano
Utah PLAY Project Home Consultant
Early Intervention for Kids with Autism

Sensory Overload - Autism and the Doctor's Office


Sorry!  I meant to post this earlier.

I was trying to think of instances when someone might be excited to go to the doctor.  I asked a friend, and she came up with a few.  When a woman is going to find out if she's pregnant, when you're having a procedure done that will make your life better...like lasik eye surgery, when you know it's the last time you have to go after a long series of visits (but my guess is that you're more excited about the prospects of not having to go again rather than actually going.)  Ok, I guess there's a few, but let's be honest...even these visits cause a lot of anxiety.  When I had lasik eye surgery done, they offered Valium for the anxiety.

My conclusion...doctor visits cause anxiety.  And let's recall from my post about the brain, that the amygdala (it's weakness being low tolerance for stress and anxiety) is 4 times as big in a individual with autism.

Ok, so here goes my list of some (not all) reasons why going to the doctor can cause sensory overload for some kids (and adults) with autism.  In a future post I will share an experience that one mother shared with me of how her doctor made it such a successful visit with her son with autism.
  • The anxiety of going to the unknown
  • This trip is not part of my daily routine
  • When we arrive, we have to wait to check in
  • Mom or dad is filling out paperwork instead of paying attention to me
  • I get yelled at every time I walk away 
  • Florescent lights flickering
  • Phones ringing
  • TV playing, but it's not my favorite show
  • Waiting to see the doctor
  • Someone calls my name, and we are taken through a door to the unknown
  • They make me stand on a scary looking machine to weigh me, but I don't know what that means
  • I get in trouble when I don't stand still on the scary machine
  • I am taken to a little room, and I have to wait...again
  • They make me sit high in the air on some crinkly paper that doesn't feel good
  • It smells weird
  • There are objects around me that don't look familiar
  • A stranger comes in and gets in my space, looking at my eyes, in my ears, in my mouth, etc.
  • This same stranger has a some weird things coming out of his ears and he wants to put it on my heart, but I don't know why.  It's cold and uncomfortable.
  • Sometimes another stranger comes in with pokey things and she stabs me with them, and it hurts
  • After I cry for a while, I get to leave

Joy Mano
Utah PLAY Project Home Consultant
Early Intervention Services for Children with Autism


photo credit: Joe Shlabotnik via photopin cc

Show and Tell: 10 Little Bumblebees


It's Friday!!!  That means I get to share one of my favorite things.  This week I want to share with you one of my favorite circle time songs.

I think one of the reasons I like this song so much is because I love the props my staff helped me make. They're so cute, and so easy to make!

What you need: black gloves, yellow duct tape

As you can tell from the picture we just took strips of tape and put them around the fingers.  We also made cute little antennas, but if I were doing it again, I would just forego that part.  Most of them were either ripped off or chewed off.

Why I love this song and the props, in no particular order :)

  • We're learning about numbers
  • Putting on gloves is good fine motor work
  • Getting tactile input from the soft gloves
  • Learning to tolerate gloves for the winter season
  • Kids ask for help when they need it
  • Finger isolation when singing the song
  • Imitation skills
  • Proprioceptive input with tickling.  I like to tickle when the bees are buzzing all around
  • Kids share as we have one or two students pass out the gloves
  • Clean up, learning to put things away and waiting a turn to put their props back int he box
  • Attending.  Music is always a great motivator for attending and staying seated
For some reason Amazon isn't letting me add anything to my Astore today, but I'll add this song to my Amazon Favorites when I get a chance.  For now, here's a link to a sample of the song.  10 Little Bumblebees.

Joy Mano
Utah PLAY Project Home Consultant
Early Intervention Services for Children with Autism

Autism and the Brain


Last week I attended an Autism Conference at Utah Valley University.  One of the workshops I attended was about the neurological difference associated with ASD.  I thought it was so interesting, and I learned a lot so I wanted to share it with you.  The presenter was Brandon Condie, BCBA, LPC.

He talked about 5 main areas of the brain, including the amygdala, hippocampus, frontal lobe, corpus callosum, and cerebellum.  The thing that I found interesting was the strengths and weaknesses of each of those areas.  It just makes so much sense if you know many individuals that are affected with autism.

Here we go.

Amygdala.  In an individual with autism, this area is enlarged.

  • Strengths include improved memory for interests and details.  Makes total sense for those individuals who know EVERYTHING about their special interest.  Makes sense for those who have Savant skills.
  • Weaknesses include a low tolerance for stress and/or anxiety.  When I heard Temple Grandin speak last year she mentioned that her amygdala is 4 times the size of a typical brain, which meant that her fear center was 4 times as big.  We see this a lot where a situation that doesn't seem frightening to us may be completely overwhelming to an individual with autism.  This explains a lot.
Hippocampus.  This area is also enlarged in an individual with autism.
  • Strengths include being logical, and is systems oriented.  Many individuals with autism excel in areas like engineering, math, etc.  We marvel at those kiddos who are unable to communicate, yet they are able to navigate things like the dvd player, ipads, computers, etc. with very little help and at a very young age.
  • Weaknesses include perseveration.  We see this in a lot of individuals with autism, once they are focused on something it is difficult to change directions.  Whether it is a topic of conversation, lining things up, or making sure everything is where they feel like it needs to be.
Cerebellum.  In an individual with autism, they may have overloaded white matter.
  • Strengths include a need for routine, and becoming an expert at a task.  As many parents know, routines and predictability are so important for individuals with autism.
  • Weaknesses include unsteadiness, delayed physical or verbal response, and anxiety surrounding sudden change.
Frontal Lobe.  The frontal lobe is enlarged due to excessive white matter.
  • Strengths include being visual learners.  Temple Grandin talks a lot about how she sees the world in pictures, and all her memories are in pictures.  That's why she's so good at what she does.
  • Weaknesses include having a difficult time with abstract thought.  This may be part of why social interactions are so difficult as well because they are not concrete.  Some of our rules as pertaining to social interactions are abstract.
Corpus Callosum.   This area is undersized.  The corpus callosum links the two hemispheres of the brains and is the source for effective communication between the two hemispheres.
  • Strengths include being able to hyper-focus on detail
  • Weaknesses include missing the "bigger picture" and being able to bring concepts together.
Learning about this information was so eye opening for me.  I've worked with a lot of kids with autism, and I see common characteristics and I know how to work with their strengths and their areas of struggle, but learning about the brain helps me to see more of the WHY. 

Joy Mano
Utah PLAY Project Home Consultant

Early Intervention Services for Children with Autism


photo credit: Patrick Hoesly via photopin cc

Repetitive Behaviors and Autism



So I've talked about the first two areas of concern in autism, which are social interactions and communication.  The last area is repetitive behaviors.

As a recap, according to the DSM IV these are the requirements for a diagnosis of autism.
  • At least two symptoms from the area of Social Interaction are present
  • At least one symptom from the area of Communication is present
  • At least one symptom from the area of Repetitive Behaviors is present
  • A total of 6 (or more) items are present from the 3 areas listed above
  • Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years:
    • Social interaction
    • Language as used in social communication
    • Symbolic or imaginative play
  • The disturbance is not better accounted for by Rett's Disorder or Childhood Disintegrative Disorder.
Ok, let's talk about Repetitive Behaviors.  Like I said above, at least one of the following is present.
  • Encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
  • Apparently inflexible adherence to specific, nonfunctional routines or rituals
  • Stereotyped and repetitive motor mannerisms (e.g. hand or finger flapping or twisting, or complex whole body movements)
  • Persistent preoccupation with parts of objects
What does this look like?

Restricted patterns of interest.  The key to this area is the intensity and focus.  We all have interests, but it is the intensity and focus on that interest that can become disruptive to every day life.  For some it may be a subject like trains, dinosaurs, trucks, star wars, etc.  It may become the only thing the individual will talk about and can have an effect on relationships and school depending on how focused they are on that subject.  For others it may be in lining things up, or matching objects.  This can affect ones life when the intensity is so strong that they have a meltdown every time things are not how they would like them to be lined up.  

Specific, nonfunctional routines or rituals.  Just like we have our own rules for things, and I'm sure that some individuals with autism don't understand our rules...some individuals with autism have their own rules and we just don't get it.  I had a student and his "rule" was that he had to enter the building through a certain door.  I didn't know about this "rule" and it took a while before I figured it out, but if he went through the right door instead of the left door (even if we already made it halfway down the hallway) he would have to turn around go back outside and come in through the left door.  This was a behavior that was specific, nonfunctional and turned into a ritual.

Repetitive motor mannerisms.  Many of us have little movements that we do when we are in stressful moments, or when we are trying to pay attention.  For example, when we are sitting in a meeting all day, we tend to get restless.  We start to bounce our leg, or tap our pencil on the desk.  Once again what this is looking at is the intensity and focus.  Many individuals with autism have repetitive behaviors that may begin as a coping mechanism for them but can easily turn into habit.  Some of these repetitive behaviors may be hand flapping, walking on tip toes, spinning, darting across the room, flicking their fingers in front of their eyes, etc.

Preoccupation with parts of objects.  Sometimes you will find that individuals with autism focus on parts of objects rather than looking at the object as a whole.  For example rather than playing with a toy car, the child may be overly focused on the tires.  Instead of using the toy functionally, they may only spin the tires.

Repetitive behaviors can be all consuming and may affect an individuals ability to function fully in their environment, however that information can be very useful as we learn to interact with each individual. 

If you have any concerns about your child's development, please contact your doctor.

Joy Mano
Utah PLAY Project Home Consultant
Early Childhood Autism Services

photo credit: KellBailey via photopin cc

Show and Tell -- Duck Duck Moose Apps


If you haven't tried the Duck Duck Moose Apps, you really should.  They are great for kids.  With familiar tunes, great animations, and interactive activities how could you go wrong?

Here's more reasons why I love the Duck Duck Moose Apps.

  • Great cause and effect applications
  • Counting games
  • A lot of actions that you can talk about with your child while he's playing.  "Hey! You made him jump!" "He's climbing his web."  Etc.
  • You can sing with it, or sing alone with the accompaniment
  • You can record your child singing it
  • Kids love it and stay engaged with the learning activities
Try some out if you haven't already.  They are between $0.99 and $1.99.

Communication and Autism

On Monday I focused on the area of Social Interactions in regards to the DSM IV (how autism is diagnosed.)  Today I'm would like to continue on to Communication.  As I said in my last post, just because someone has some of these characteristics, does not necessarily mean they have autism.  They must also meet the criteria in the areas of Social Interaction and Repetitive Behaviors.

According to the DSM IV, at least one of the following are present.

  • Delay in or total lack of, the development of spoken language (also without gestural communication)
  • Individuals with adequate speech have a marked impairment in the ability to initiate or sustain conversations
  • Stereotyped and repetitive use of language or idiosyncratic language
  • Lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level
Spoken Language and Gestural Language.  Many times the lack of spoken language is the most obvious sign for parents that their child may have delays.  Typically, kids should have several  consistent words they are using by 18 months.  You would start seeing more gestural communication, like pointing, around 14 months.  Here is a great blog about language development (Playing With Words 365), and particularly, here is a post about red flags in communication.  It gives some great timelines on language development.

Initiating and Sustaining Conversations.  There are some kiddos who have tons of words they know, but making their words functional can be more difficult.  Conversations are a give and take process, we build relationships when we have good conversations.  Some kids may know how to talk, but they do not participate in a back and forth interactions with others.  Some kids are good at responding, and will answer questions, but will not go further than that.  Others will initiate, but will rarely let others respond, thus they are very good at the giving part, but not so much at the taking part.

Stereotyped and Repetitive Language.  Some parents will report that their children speak in movie quotes.  Sometimes it's in context with the situation, but a lot of times it is not.  Some kids may get fixated on certain phrases and will repeat them continuously.  Other kids will repeat what you say or other things they hear, this is called echolalia.  Echolalia includes when they immediately repeat what they hear, or they may also repeat what they heard hours ago.

Make-believe Play or Social Imitative Play.  Make-believe can be difficult for some kids with autism because it involves an understanding of what other people are feeling and doing.  It also requires imitation skills.  When playing with others in pretend play, this skill also requires that the child is able to see the points of view of other people and explain his/her point of view to them to create the experience that they want.  Many kids with autism prefer to play on their own, and may focus more on sensory type play.

Joy Mano
Utah PLAY Project Home Consultant
Early Intervention Services for Children with Autism



photo credit: Diego Dalmaso via photopin cc

Social Interactions and Autism


According to the DSM IV (which I mentioned earlier will soon be DSM-5 as early as May 2013), at least two of the following are present in the area of Social Interaction when an individual is being diagnosed with autism.
  • Marked impairments in the use of multiple nonverbal behaviors such as eye contact, facial expression, body posture, and gestures to regulate social interactions
  • —Failure to develop peer relationships appropriate to developmental level
  • A lack of spontaneous seeking to share enjoyment, interests, or achievements with other people
  • —A lack of social or emotional reciprocity
Now just because someone has some of these characteristics, doesn't mean they have autism. They also have to have symptoms in the areas of Communication and Repetitive Behaviors, which I will talk about next week.

Let's break this down a little.

Eye Contact.  Sometimes eye contact can be very aversive to a person with autism, you may get occasional glimpses here and there, but it can be fleeting.  As you go through your day, take note to how much we communicate with our eyes.  It can be very difficult to teach someone to communicate and read "eye language", it's all so subtle.  You can see how that can affect someone's social skills.

Facial Expression.  You may or may not have heard the expression "flat affect."  Sometimes individuals with autism show very little expressions through on their face.  They have the same expression when they're bored as they do when they're excited.  Other times you may find that their facial expressions are a bit rigid and unnatural.  Again, reading facial expressions can be difficult for some people with autism, but in general it's a bit easier to teach than reading the eyes.

Body Posture and Gestures.  How often do we communicate with gestures?  All the time!  Many times, young kids with autism are unable to follow a point or use a point themselves.  We point with our fingers, and we point with our eyes for joint attention.  We are having an interaction as we are both focused on the same thing.  Gestural communication is very important in our social interactions.  It is usually learned through imitation, which many kids with autism are lacking in.

Peer Relationships.  There are different types of play, and depending on the child's age, different types of peer interactions are more appropriate than others.  Usually when parents start to see the gap is when it is time that their child should start socializing with their peers (associative or cooperative play.)  For some kids, they would rather participate in solitary play away from everyone else.  Some kids are only able to play near others for short periods of time.  For other kids they may want to play with other kids, but they don't know how to join in, or they don't know how to participate.  Some kids are able to talk, but they lack the understanding that conversations should be a give and take exchange.  And some kids like playing with others, but they have a hard time when they don't have total control over the activity.  All of these things can affect peer relationships.

Sharing Enjoyment.  At a young age kids will pick up a toy to show their mom.  Typically a toddler will learn the phrase "look" or "look at me!" and will use it quite often.  Once again, that is part of joint attention.  Focusing together on one thing.  Some kids with autism will not participate in exchanges like this.

Social or Emotional Reciprocity. When we are connected to each other, we have back and forth interactions with one another.  We are able to read each others gestures, their tone of voice, their emotions, and their words.  We take these things as cues and we respond to them accordingly.  Many people with autism have a difficult time with this because they lack theory of mind.

Joy Mano
Utah PLAY Project Home Consultant
Early Intervention Services for Children with Autism


photo credit: MikeWren via photopin cc

Show and Tell--Play Food

PLAY FOOD
There are so many reasons why play food is great.  First it's something that the child has hopefully seen and possibly experienced first hand.  We're talking imitation skills here.  Because a child usually has first hand experience watching his mom (or dad) prepare food, he/she is able to have an idea of what to do with this food.  This is where pretend comes in.  First it will just be imitating the motor actions, but then it can turn into thematic play.

This particular food is great because it also incorporates fine motor skills.

So here's my list of things to do with play food in random order (aka, however it comes to my mind)

  • Have a picnic
  • Feed stuffed animals or puppets
  • Play the "like it"/"don't like it" game.  Make funny faces as your child "feeds" you, and over exaggerate when you like it or don't like it.  Then do the same thing with the puppets
  • Match the pieces of food that go together
  • Match the food to pictures of the food
  • Categorize the food
  • Cut the food and prepare a meal
  • Be a waiter and take the child's order or vice versa
  • Make a stew
  • Set the table before you eat
  • Have a tea party
  • Plant the food in a sandbox or sensory table

Symptoms of Autism

We are all different.  Agreed?  Yes, we may have some similarities, but we are still very different.  The person that I am probably the most like is my best friend, sometimes it's scary how much we think alike.  But, we are still very different.  One big difference is our career paths, I work with kids with autism and she is an accountant.  My sister-in-law is an identical twin, yes her and her sister look very similar, but they are very different.

What does this have to do with the symptoms of autism?  Well, I just want to emphasize that just because two people have the same diagnosis, they are individuals and are most likely very different from one another.  And although two people may have deficits in the area of communication does not mean that their deficits look the same.  It's a spectrum.  The diagnosis of autism is based on observation, and to be diagnosed with autism, the individual does not need to have 100% of the symptoms.

There are 3 common areas that are affected in individuals with autism.  They include social interaction, communication, and repetitive behaviors.  I will go into more detail about each area in upcoming posts.  If you have any concerns though, please contact your doctor.

Whether your child has a diagnosis or not, the thing that I think is important is that you find out where your child needs the most help and you put your efforts there.  I believe that individualizing the treatment is far more important than saying autism=a specific type of intervention.  There is not yet a cure for autism, BUT there are a lot of interventions that can help an individual improve and gain skills to be able to function more fully in this crazy/wonderful world we all live in.

Joy Mano
Utah PLAY Project Home Consultant
Early Intervention Services for Children with Autism

photo credit: read4thefunofit via 
photo credit: superhua via photopin cc
photopin cc photo credit: jshj via photopin cc

Happy Autism Awareness Day!


I love it when the whole world is able to come together for one purpose whatever it may be.  Today is the Sixth Annual United Nations World Autism Awareness Day.

Hopefully as you go around your community today you will see people who are shining a light on autism by lighting it up blue.  And if not, then perhaps next year you will be the one to do it.

I posted about this yesterday, but it's not too late to get a banner or logo for your facebook/twitter/pinterest/etc. accounts.  Just go to www.lightitupblue.org.

Joy Mano
Utah PLAY Project Home Consultant
Early Intervention Services for Children with Autism

photo credit: BC Gov Photos via photopin cc


Happy Autism Awareness Month!


April is Autism Awareness Month, so I would like to focus my April posts more about Autism.  I hope to be able to give some insight into the 3 core deficits of autism, which include social interaction, language, and repetitive behaviors.  

As many of you know, the way that Autism is diagnosed is undergoing some changes.  It may be as early as next month when the DSM IV (Diagnostic and Statistical Manual of Mental Disorders) will change to the DSM-5.

Here's the thing about the diagnosis changes, I am more concerned about your child as an individual.  What are his/her strengths?  Where is he/she struggling?  Regardless of whether he/she has a diagnosis of autism, I want to look at what we can do to strengthen those areas of concern.  So even though the criteria I am going to be discussing is going to be outdated next month, I'm still going to try to look at those areas of deficit and put them into terms we all can understand.

I will start those posts later this week.

Here's some other random info:

My Community Ed class that I am teaching in Sandy, Utah begins tomorrow.  You can go to register.playwithjoy.com or you can just show up and we can take care of registration before class begins.  It is at 6:30 pm, April 2 at the CTEC (825 East 9085 South)

Tomorrow begins LIGHT IT UP BLUE.  If you don't know what that is, check out www.lightitupblue.org.  They also have banners and logos you can download to add to your facebook or twitter accounts.  Light it up blue is the kickoff to Autism Awareness Month around the world.  It's pretty awesome how the world comes together to help spread the word about autism.  Check out the amazing photos including The Great Pyramids, The Sydney Opera House, and many more amazing places around the world.

April 11, 2013 is the Annual Autism Council of Utah Meeting.  Everyone is invited to attend.  It will be at 9:00 am at the Capitol.

Show and Tell--Icky Sticky Bubble Gum


Icky Sticky Bubble Gum

This preschool song is always a favorite.  I like using it for learning body parts or clothing.  It's a great song for working on imitation skills as well.  You can choose what your hands are getting stuck to, or you can pause and wait for the kids to choose.  The kids always love this song.

You can listen to a sample of this song by David Landau, or buy it on my amazon picks here.

And here are the words:

Icky sticky sticky sticky bubble gum bubble gum bubble gum

Icky sticky sticky sticky bubble gum makes your hands stick to your head
And you pull them and you pull them and you pull them away


Icky sticky sticky sticky bubble gum bubble gum bubble gum

Icky sticky sticky sticky bubble gum makes your hands stick to your ________
And you pull them and you pull them and you pull them away

Joy Mano
Utah PLAY Project Home Consultant
Early Intervention Services for Children with Autism


photo credit: @Doug88888 via photopin cc

My dream list


This is just a random post about me and my dreams.  It's been on my mind a lot lately, so I thought I'd share.


A little background: In 2005 I made a list...some would call it a bucket list.  It stayed filed away for the next year or so, it was just a list.  Towards the end of 2006 I suddenly had the realization that I could actually do some of the things on that list, so I started to prepare.  In 2007 I moved to Ecuador to do one of the first things on the list...work in an orphanage.

Since that time, my list has shrunk...and grown.  I've been able to cross of a lot of things, and add a lot more.  It's been pretty amazing, and fun, and fulfilling.  Some things on my list that I initially thought would be "once in a lifetime" experiences have actually become such a big part of my life that they will never be a one time thing.

One thing I've learned about dreams is that we don't have to know how it's all going to work out.  There are so many times in our lives that we say "that will never happen" so we don't do anything about it, we don't even put it on our dream list.  So I've learned to put those things down.

I have a few passions in my life.  One of them is humanitarian work, another is autism, and another is kids.  So, why not combine them all?  

I would love to some day be able to start a program in a developing country working with orphans with disabilities.  There are a lot of orphanages out there, but unfortunately they are usually understaffed, and they are rarely trained in working with kids with disabilities.  I would love to be able to build a program where kids receive the intervention that they need early in their lives.  I obviously don't have all the logistics worked out, but some day...

I received an e-mail the other day from a lady who is part of a program in China where they train nannies to work with kids rather than having the kids live in an orphanage.  It sounded like a great program, and it made me think that it is possible, and some day I can do that.

May your imaginations run wild, and your dream lists grow (and shrink), and may the things you never thought were possible...happen.

Joy Mano
Utah PLAY Project Home Consultant
Early Intervention Services for Children with Autism

Community Ed Class Begins Next Week

Sorry for all the presentation flyers, but just another reminder that next week my Community Ed Class begins on April 2, 2013.  You can register by going to register.playwithjoy.com.  I hope to see you there!

PLAY Presentation in Weber County, Utah

Just a reminder I am presenting this coming Wednesday in Weber County.  If you are interested in learning about what the P.L.A.Y. Project is, please join us at 7 pm.  Thanks!


Show and Tell - TOMY Gears


The TOMY Gearation Building Toy has always been a favorite in my preschool class.  Yes, you have to be careful because it can also turn into a toy that some kiddos will turn into a self-stimming toy, but overall it's a great toy.  This isn't necessarily a great toy for "following a child's lead" or PLAY Project, but I still like it for other reasons.

Reasons I like this toy:
  • You can make different designs/connections with the gears.
  • Some of the gears do fun things like make noises or have parts that flip.
  • It can be a great reinforcer by giving one piece at a time when you're doing more discrete trial type teaching.
  • You can give a child a choice between two pieces.
  • You can hoard the gears and work on requesting by the child.
  • You can take pictures of the gears, and then do a matching game where the child has to find the matching piece to put on.
  • You have to do some problem solving if not all the gears are moving.
Joy Mano
Utah PLAY Project Home Consultant
Early Intervention Services for Children with Autism