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Reclamation Games: Non-Autistic Aspects in the Young Autistic Child Alerting the Young Autistic Child to Social Communicative Delights

*There are some games that are ideally suited to attract the young developmentally delayed autistic child into human social communication.

They encourage an emotive feelingful approach from the adult in order to develop and ‘reclaim’ dormant healthy developmental potential.

Their aim is to draw the autistic child into social interaction, and to find it so much fun that he wants more of this typically human social ‘stuff’ called communication and play. They are based on the view that all human beings are born to be social creatures, ‘designed’ to have complex feelings, ideas and internal worlds. This implies that there are non-autistic aspects in even in the most avoidant, delayed, disabled or autistic child. It is these we want to find, reach, awaken, alert him to, and ultimately ‘reclaim’ (Alvarez 1992). With the autistic child this involves the adult in knowing where we may expect to find him, how to reach him, what to do to wake him up, and how to alert him to our presence, to his own cut-off-ness and the social communicative delights that would ease his isolation.

Such knowledge can be gained from a triad of approaches: 1) research of infant development, 2) emotionally informed infant observation, 3) and the attentive study of the nature of the child’s mental state, internal world, and its interrelatedness with that of the adult (i.e. modern British psychoanalytic object relations theory). All of these share the idea that the crucial foundations for all physical, social, cognitive, emotional and language development are laid in the baby’s earliest social play: first a child/ baby needs to have discovered the joys of ‘joint attention’ which is the beginnings of meaning. This leads to ‘social referencing’, without which there can be no meaningful communication, no symbolic or speech development.

The mental, communicative and socio-emotional development of the autistic child is often delayed around the level of a 4 - 9 month old. As all development is a process of growth, with new achievements relying on previous ones, we must pitch our efforts to engage him at these early developmental levels. Understanding how babies communicate and play gives us a mental model for ‘reclaiming’ the young autistic child into human social interaction.

The earliest ‘games of pure interaction’, intuitively played by adults and babies all over the world, usually last only a few minutes involving nothing other than face-to-face contact, vocal sounds and touch. They are non-symbolic and are played without the help of toys or other objects, using whatever traces of instinctive interest and responses. In the following example of 4.5 month old Joey and his mother, Daniel Stern illustrates beautifully the nature and process of these early communicative games, how the ‘players’ respond when the child’s ‘optimal range of frustration’ is overstepped, and how they negotiate a return to each other’s emotional company:

“Joey is sitting on his mother’s lap, facing her. She looks at him intently but with no expression on her face, as if she were preoccupied and absorbed in thought elsewhere. At first, he glances at the different parts of her face but finally looks into her eyes. He and she remain locked in a silent mutual gaze for a long moment. She finally breaks it by easing into a slight smile. Joey quickly leans forward and returns her smile. They smile together; or rather they trade smiles back and forth several times. Then Joey’s mother moves into a gamelike sequence. She opens her face into an expression of exaggerated surprise, leans all the way forward, and touches her nose to his, smiling and making bubbling sounds all the while. Joey explodes with delight but closes his eyes when their noses touch. She then reels back, pauses to increase the suspense, and sweeps forward again to touch noses. Her face and voice are even more full of delight and ‘pretend’ menace. This time Joey is both more tense and excited. His smile freezes. His expression moves back and forth between pleasure and fear. Joey’s mother seems not to have noticed the change in him. After another suspenseful pause, she makes a third nose-to-nose approach at an even higher level of hilarity, and lets out a rousing “oooOH!” Joey’s face tightens. He closes his eyes and turns his head to the side. His mother realises that she has gone too far, and stops her end of the interaction, too. At least for a moment, she does nothing. Then she whispers to him and breaks into a warm smile. He becomes re-engaged." (Stern (1991): Diary of a Baby)

Joey seems to be looking not only at but for his mum in the sense of wanting to make emotional contact with her. With his long silent look into her eyes he eventually gets her to ‘hear’ his unspoken question, and without words they play a question-and-answer game, have an argument, fall out, apologise, and make up again. When his mother oversteps his level of tolerance, Joey has no alternative than to shut off, displaying avoidant behaviours to help him cope, and to preserve his emotional balance (an older child may have run away). When he has regained it, he returns emotionally to their interaction.
relationship, contact ....*

Confirmed by recent research (e.g. Murray & Trevarthen, C. 1985, Alvarez 1992, Alvarez & Reid 1999), this suggests that some autistic cutting-off maneuvers may have started on a much smaller scale as a baby’s meaningful coping strategies which have subsequently become entrenched and habitual. In this example simply waiting in silence, attention tightly focussed on the other, letting some suspense build up as a natural motivator, is used first by Joey to alert his mother, and later by her to allow him to settle again. / ... before returing to her *

These early ‘looming games’ (***), in which the adult suddenly and playfully sweeps forward and into the child’s field of vision, saying something like a high-pitched “hello hello helloooo!” before reeling back again, play on some instinctual communicative potential that is usually unimpaired and reachable, even in the passive or avoidant autistic child.

Tim (age 3) was an expert in avoidance. Passively lying in a corner as usual, his immediate response to a ‘looming game’ would be to simply shut his eyes or turn his head. But by first moving my face back a little together with a noisy warning-gasp, I could catch his attention so that we would be looking into each other’s eyes, at least for a split second! If I burst out immediately into an exaggerated smiling ‘greeting face’ accompanied by a high-pitched welcoming “Hellooo?! Hello TIM!!?!”, and followed by more surprising and unexpected mouth shapes and noises, like blowing raspberries, ‘plopping’ my lips, wiggling my tongue quickly and noisily from side to side, always a little different, I could hold his focussed interest for perhaps a few more seconds, or even minutes.

Compared with the fleeting split seconds he has become used to, minutes are a long time for Tim who normally seems incapable of such human connectedness and contact. Here were islands of unexpected possibilities to promote this non-autistic human potential.

The autistic child needs an adult, who is sensitive to his individual levels of tolerance, to pull him out of his reduced world of cut-off-ness or auto-stimulation into a more alive animated human relationship, by always tugging lightly (or perhaps vigorously) at his mental capacities to respond to such playful human company. Through observing closely, always with the question “What can I do with that?” in mind, opportunities can usually be found where a glance, a vocalisation, a hand or foot movement can be echoed and turned into a little interactive game by adding a little thrill of surprise, an edge of anticipation. Running away can be made into an interactive “I’m gonna getcha!”-game, or a less pushy “I can still see you!”-game for those children who get too scared by being followed, caught and tickled.

The ‘mouth and face games’ I play with young autistic children are also simply a larger-than-life version of these baby-games of ‘pure interaction’. The human face is better equipped for this than anything in the world: with eyes and a responsive voice, guided by a thoughtful and feelingful mind, an interest in careful observation, sensitive awareness of our own pre-verbal communicative potential, a willingness to wait, watch and respond rather than to teach and demand, and to keep our concentration tightly focussed on the child’s face and subtle communications, it is really the most amazing cause-and-effect toy ever invented. Patrick (age 4.5) adopted ‘mouth-and-face-games’ as if he had been craving for something like this:

Always active, it took some time to get Patrick to sit down. To catch his attention I made the most peculiar noise-sequence I could think of with my mouth. He looked up with sudden interest, or suspicion. I did it again, my mind expectantly focussed on him, but paused mid-way waiting for him to complete the sound-sequence. When he did not, I completed it myself more quietly rather than let our hard-won ‘joint attention’ go. But then he seemed to try, blowing and pressing his lips together, and I echoed him. He did it again, more confidently, and we traded ‘raspberries’ a few times. I added a tongue-click, and waited for him to try. He did. We now had a ‘dialogue-game’: ‘raspberries - tongue-click - : your turn!’. I added a tongue-wiggle, which he copied. .... And then it was my turn to be surprised. Patrick’s response was:“‘raspberries’ - tongue-click - vocal sound - punch air and shout!” He looked at me with a broad grin, and I copied his expanded version. After 10 minutes he still did not want to stop.

To make these communication games successful, the adult needs to create a sense of anticipation and suspense, often achieved by doing nothing: just waiting, our attention expectantly focussed on the child, like stretching and stretching an imaginary elastic (usually about 10 times longer than thought possible), increases suspense naturally. An expectant atmosphere in which nothing is happening can be made to produce a grating sense that "something must be up!": he will have to look at our face to find out!

There are two guiding ‘principles’ I always keep in mind. One I call ‘walking the tightrope between fear and delight’. For both Patrick and Tim ‘it’ had to be tight and exciting enough to keep their attention on tenterhooks, careful not to let them slip off into a more flaccid state of mind. With Joey we saw how ‘it’ fell off the tightrope, and he needed time to get back up again. I also always remind myself to ‘make it bigger’. The more unresponsive the autistic child, the more the adult feels hopeless and helpless at being able to engage him socially, and the more we need to ‘make it bigger’, i.e. being more dramatic, more emotionally engaging, using more expansive movements, more ‘stretch’ in our suspence, exaggerating how we speak, its speed, its pitch, its tones. Sometimes this means moving exaggeratedly more slowly, or stopping suddenly, or whispering. We need to make our presence unavoidable for him, but in such fun ways as not to put him off, should he risk coming out of his shell.

However, ‘making it bigger’ does not simply mean more, harder, louder, faster, but tuning in sensitively to the child’s feeling-state and making it into a shared experience.

Mandy used to approach Kofi (age 3) by talking loudly to him in a shrill voice. The more he withdrew, the louder and more persistent she got, the closer she would sit, holding his hand harder whenever he wanted to run away.

Although she was using the idea ‘make it bigger’, Mandy’s approach lacked sensitivity, playfulness and suspense. Unaware of the effects of her behaviour on him, she neglected to take into consideration Kofi’s likes and dislikes (he hated any loud, and especially shrill, noise). Adults who approached him more slowly and quietly, were much more successful with Kofi and felt less hopeless about him too.

The success of these games hinges on the adult’s understanding that they are not educational in a functional sense, but about playing with intentions and feelings, about building up expectations, and then stretching, breaking, re-making and mucking about with them, always ‘walking the tightrope between fear and delight’. It is probable that the child actually feels somehow threatened. But there is something odd about this so-called ‘threat’: it is coming at him and disappearing, or changing, too fast for what would instinctively qualify as a serious threat. The moment he is ready to retreat or run away, the threat itself has retreated. What is going on here? Where has it gone? The child cannot withdraw safely, because that threat is still hanging around somewhere. So he’s got to look. The repeated sudden disappearance of the ‘threat’ coming at him draws his attention to it, his curiosity is engaged, his mind alerted, his senses drawn together into one focus, so unusual for the autistic child, - and so good for him.

Running to and fro as usual, Fred’s (age 4) keyworker Linda would slowly creep up on him, and he never knew whether she would suddenly pounce and tickle him, or stop dead, - or in fact what on earth she might do! Soon he would sometimes run away, then suddenly stop to look back laughing, or let himself be caught. Occasionally Linda asked him to put on his shoes, but then put them on the 'wrong' child, or pretend to put them on herself. This made Fred, usually not prone to cooperating, come running to rescue his shoes. At dinnertime she might offer him a spoonful of food, holding it in mid-air for a long time without moving, and then, just when he thought she was going to force-feed him, - put it back on the plate or eat it herself, ....

If the adult manages to create a situation that is ambiguous enough to arouse the need for curiosity, carefully scaffolded in an atmosphere of friendly affection, then the young autistic child is usually drawn to engage and interact socially in similarly unexpected ways. Some responsive non-autistic capacities may have been hibernating, waiting to be claimed and re-claimed through moments of playful communicative contact, to thrill and enliven the passive or withdrawn child, and the desparing or worn out adult too.

BIBLIOGRAPHY AND RELATED READING:

Alvarez, A. (1992) Live Company. London: Routledge

Alvarez, A. Autism and Personality. London: Routledge

& Reid, S. (1999)

Frith, U. (1989) Autism: Explaining the Enigma. Oxford: Blackwell

Hobson, P.R. (19930 Autism And The Development Of Mind. Hove: Lawrence Erlbaum

Hocking, B. (1990) Little Boy Lost. London: Bloomsbury

Janert, S. (1995) Play in the First 6 Months. In: Nursery World, Febr.

(2000) Reaching the Young Autistic Child. London: Free Ass. Books

Murray, L. & Emotional Regulation of Interactions Between 2-Month-Olds and Their Trevarthen, C. (1985) Mothers. In: T. Field & N.Fox: Social Perception In Infants. Norwood, N.J.: Ablex

Stern, D. (1977) The First Relationship: Infant And Mother. Cambridge MA: Harvard UP,

(1985) The Interpersonal World Of The Infant. New York: Basic Books

(1991) Diary of a Baby

Trevarthen et.al. (1996) Children with Autism. London: Jessica Kingsley