Rhea Paul and Donia Fahim
Parenting, Therapy Tips 
Rhea Paul and Donia Fahim, authors of Let's Talk: Navigating Communication Services and Supports for Your Young Child with Autism, have offered to answer questions from Friendship Circle readers on how to help your child with autism learn, play, communicate, make friends, succeed at school, and get the best services. If you'd like to submit a question, add it in the comments here or on our Facebook page, and you may find the answer in a future blog post.
I have a 5-year-old with ASD. He repeatedly calls "Mommy" or "Daddy" and asks "How are you?" and wants the reply "I am fine" or "I am good" and for us to ask him the same question. This is done every three to five minutes if he is watching a TV show he really likes, such as bull-riding, The Voice, or Wheel of Fortune. He gets really excited during these shows. He has recently changed his response to "How are you doing?" from "I'm okay" or "good" to "no" or "not" sometimes. It is the same with a statement he makes: "I love you." We respond "I love you too," and he either says "Love you too" or "no." His behavior is not negative; it is more a teasing playful "no," and he will hide his face then pop up to repeat it again. He has other behaviors we are not sure of, and we want to know how to learn what his meaning is to help him with his language, because he has a huge vocabulary. This is a new diagnosis, and we have not met with the doctor since diagnosis. Thanks for any help you can provide. — Anita
Dear Anita —
Your description makes it sound as if your 5-year-old is trying very hard to communicate with you, but despite his large vocabulary, he doesn't know how to create novel ways to do it, so he relies on the "tried and true." This kind of behavior is quite common in children with ASD, but it is a good sign that he is deeply interested in interacting.
This is especially the case since you detect the "teasing" tone in his manner; this suggests he enjoys the interaction and is trying to engage you. There are several ways to approach this issue. The main thing to remember is that you want to encourage him to continue to seek interaction, but at the same time, help him expand his repertoire of ways to interact.
A behavioral approach would be to ignore the behavior you want to change and replace it with a more adaptive one. For example, the second or third time he asks, instead of going through your usual script, you might say, "Let's sing 'Wheels on the Bus' together" and get him started singing with you, or you might say "Let's play Simon Says" and play a few rounds with him. The important thing is to respond with a different suggestion each time, so that your new tack doesn't become a routine. If he persists with the script, smile, shrug your shoulders, and say, "I already told you. I want to do something different," and give him another chance. If he persists, say "We'll talk later," and walk away for a minute or two.
The idea here is that you want to let him know you understand and appreciate that he is making an attempt to interact, but you don't want to repeat the same interaction every time; you want to try something new. Suggest anything he likes doing—singing, tickling, bouncing on your knee—just be sure to mix it up. Keep your interaction short. If he is watching TV, he may want to return to it, but you want to give him some alternative way to engage.
Eventually, we would hope that he might use some of your suggestions to initiate engagement. After some time, if this is successful, you might move toward giving him some more verbal strategies for interacting. For example, if he makes a bid for interaction, either with his old scripts or the new ones you introduced, you could try saying, "Okay, I like to talk with you! Tell me about your TV show." Here you want to focus on talk about something in the immediate environment that is of interest to him. This will make it easier for him to find something to say. If he has trouble, you can prompt him—for example, "I see the lady is smiling while she sings. How do you think she feels?"
Remember, it will take time for him to learn more varied ways of interacting. Don't be discouraged if this doesn't stop the behavior immediately. Like so many social skills, finding ways to engage others in things they enjoy does not come naturally to children with ASD. We need to teach them these skills that are simple intuition to other children.
Do you have any suggestions for teaching a young child with ASD to play with other kids? My son is happy playing by himself, and will play with adults or older kids who will do things on his terms, but I don't know how he'll ever be able to play with anybody who needs him to respond to what somebody else is doing. Should I even be worried about that? — Ruth
Dear Ruth —
Any parent would worry about a child who doesn't make friends his own age. You should know, though, that many children with ASD have this problem. As you observed, it is difficult for your son to understand and join in the play of others his age, often because his imagination doesn't run along the same lines as his age-mates', so it is hard for him to participate in their pretend play.
Playing with older children is actually a good first step; the older child is usually a little more willing to follow his lead and let him choose the topic of play. Although it will be a good idea for him to learn to play with peers, he may need some coaching at first. If he is in school or has a speech-language therapist, you might work with these professionals to develop some “peer models” among the children he has regular contact with.
One model that works well for this age group is a technique called “Buddy Time.” It is used in school settings and needs the cooperation of the classroom teacher. The teacher sets aside a small period of the normal playtime (recess or free play or "choice time," depending on how the class is organized) every day for several weeks as a special Buddy Time.
During this time, each child in the class is assigned a buddy, and the rules for Buddy Time are that the buddies must “stay together” for the entire buddy period (15–20 minutes) in order to win a small prize. This gives the typically developing (TD) children an incentive to “stick with” the child with ASD, who may wander off. The TD child will often work hard to stay with the child with ASD in order to ensure winning a prize.
After a week or two, the rules change so that the buddies must not only stay together but must “play together,” too, in order to win the prize. They must use the same set of toys or objects during Buddy Time. After a few weeks, the final step includes talking to each other during Buddy Time. The TD child can be prompted to call the target child’s name, or ask a question, or offer a play idea. To win their prize for the buddy period, the buddies must not only stay and play but must talk together, too.
If your school is not willing to try a Buddy Time program, you may be able to find a friend with a child your son’s age who would be willing to do something similar with your son at your house a few times a week for a few weeks. You can set up the same incentive system and encourage the children to stay, play, and talk over a series of "playdates." You won’t need to tell the TD child much, just that he or she first needs to stay together, then play with the same toys, then stay, play, and talk.
You might need to help the TD get your son to talk by coaching him to ask questions, call your son’s name, tap him on the shoulder, or use any other prompts you’ve found to be successful in getting him to respond. If you do complete this sequence at home, you might try it again with a different child, repeating the process until your son has done it with several children.
Experts Answer Your Questions on Helping Kids with Autism Interact and Play
Rhea Paul and Donia Fahim, authors of Let's Talk: Navigating Communication Services and Supports for Your Young Child with Autism, have offered to answer questions from Friendship Circle readers on how to help your child with autism learn, play, communicate, make friends, succeed at school, and get the best services. If you'd like to submit a question, add it in the comments here or on our Facebook page, and you may find the answer in a future blog post.
Finding More Varied Ways of Interacting
I have a 5-year-old with ASD. He repeatedly calls "Mommy" or "Daddy" and asks "How are you?" and wants the reply "I am fine" or "I am good" and for us to ask him the same question. This is done every three to five minutes if he is watching a TV show he really likes, such as bull-riding, The Voice, or Wheel of Fortune. He gets really excited during these shows. He has recently changed his response to "How are you doing?" from "I'm okay" or "good" to "no" or "not" sometimes. It is the same with a statement he makes: "I love you." We respond "I love you too," and he either says "Love you too" or "no." His behavior is not negative; it is more a teasing playful "no," and he will hide his face then pop up to repeat it again. He has other behaviors we are not sure of, and we want to know how to learn what his meaning is to help him with his language, because he has a huge vocabulary. This is a new diagnosis, and we have not met with the doctor since diagnosis. Thanks for any help you can provide. — Anita
Dear Anita —
Your description makes it sound as if your 5-year-old is trying very hard to communicate with you, but despite his large vocabulary, he doesn't know how to create novel ways to do it, so he relies on the "tried and true." This kind of behavior is quite common in children with ASD, but it is a good sign that he is deeply interested in interacting.
This is especially the case since you detect the "teasing" tone in his manner; this suggests he enjoys the interaction and is trying to engage you. There are several ways to approach this issue. The main thing to remember is that you want to encourage him to continue to seek interaction, but at the same time, help him expand his repertoire of ways to interact.
A behavioral approach would be to ignore the behavior you want to change and replace it with a more adaptive one. For example, the second or third time he asks, instead of going through your usual script, you might say, "Let's sing 'Wheels on the Bus' together" and get him started singing with you, or you might say "Let's play Simon Says" and play a few rounds with him. The important thing is to respond with a different suggestion each time, so that your new tack doesn't become a routine. If he persists with the script, smile, shrug your shoulders, and say, "I already told you. I want to do something different," and give him another chance. If he persists, say "We'll talk later," and walk away for a minute or two.
The idea here is that you want to let him know you understand and appreciate that he is making an attempt to interact, but you don't want to repeat the same interaction every time; you want to try something new. Suggest anything he likes doing—singing, tickling, bouncing on your knee—just be sure to mix it up. Keep your interaction short. If he is watching TV, he may want to return to it, but you want to give him some alternative way to engage.
Eventually, we would hope that he might use some of your suggestions to initiate engagement. After some time, if this is successful, you might move toward giving him some more verbal strategies for interacting. For example, if he makes a bid for interaction, either with his old scripts or the new ones you introduced, you could try saying, "Okay, I like to talk with you! Tell me about your TV show." Here you want to focus on talk about something in the immediate environment that is of interest to him. This will make it easier for him to find something to say. If he has trouble, you can prompt him—for example, "I see the lady is smiling while she sings. How do you think she feels?"
Remember, it will take time for him to learn more varied ways of interacting. Don't be discouraged if this doesn't stop the behavior immediately. Like so many social skills, finding ways to engage others in things they enjoy does not come naturally to children with ASD. We need to teach them these skills that are simple intuition to other children.
Teaching a Young Child to Play
Do you have any suggestions for teaching a young child with ASD to play with other kids? My son is happy playing by himself, and will play with adults or older kids who will do things on his terms, but I don't know how he'll ever be able to play with anybody who needs him to respond to what somebody else is doing. Should I even be worried about that? — Ruth
Dear Ruth —
Any parent would worry about a child who doesn't make friends his own age. You should know, though, that many children with ASD have this problem. As you observed, it is difficult for your son to understand and join in the play of others his age, often because his imagination doesn't run along the same lines as his age-mates', so it is hard for him to participate in their pretend play.
Playing with older children is actually a good first step; the older child is usually a little more willing to follow his lead and let him choose the topic of play. Although it will be a good idea for him to learn to play with peers, he may need some coaching at first. If he is in school or has a speech-language therapist, you might work with these professionals to develop some “peer models” among the children he has regular contact with.
One model that works well for this age group is a technique called “Buddy Time.” It is used in school settings and needs the cooperation of the classroom teacher. The teacher sets aside a small period of the normal playtime (recess or free play or "choice time," depending on how the class is organized) every day for several weeks as a special Buddy Time.
During this time, each child in the class is assigned a buddy, and the rules for Buddy Time are that the buddies must “stay together” for the entire buddy period (15–20 minutes) in order to win a small prize. This gives the typically developing (TD) children an incentive to “stick with” the child with ASD, who may wander off. The TD child will often work hard to stay with the child with ASD in order to ensure winning a prize.
After a week or two, the rules change so that the buddies must not only stay together but must “play together,” too, in order to win the prize. They must use the same set of toys or objects during Buddy Time. After a few weeks, the final step includes talking to each other during Buddy Time. The TD child can be prompted to call the target child’s name, or ask a question, or offer a play idea. To win their prize for the buddy period, the buddies must not only stay and play but must talk together, too.
If your school is not willing to try a Buddy Time program, you may be able to find a friend with a child your son’s age who would be willing to do something similar with your son at your house a few times a week for a few weeks. You can set up the same incentive system and encourage the children to stay, play, and talk over a series of "playdates." You won’t need to tell the TD child much, just that he or she first needs to stay together, then play with the same toys, then stay, play, and talk.
You might need to help the TD get your son to talk by coaching him to ask questions, call your son’s name, tap him on the shoulder, or use any other prompts you’ve found to be successful in getting him to respond. If you do complete this sequence at home, you might try it again with a different child, repeating the process until your son has done it with several children. 
