Part 1: The Importance of Following Their Lead
A few months ago, one of my students with autism who often has difficulty engaging in lengthy structured language activities came into the speech room and impulsively grabbed a book off the shelf. The book he happened to grab was a beaten up, partially ripped, much loved, several-year-old paperback book called “The Popcorn Shop.” Typically as adults, if a child happens to grab something impulsively our instinct is to hurry him or her to put it back and follow “the plan.” However, he asked me to read the book and was highly engaged in a circle of communication with me at that moment, so in an effort to keep the reciprocal exchanges of communication going, I followed his lead and attempted it. I’m so glad I did!
Knowing that attention span and engagement are two foundational areas that this child needed to build, I ‘read’ the book in my own words at a pace that I thought would meet him where he was at. He was able to get through the bare bones, using multi-sensory tools to talk about the main character, setting, problem, feelings and solution at the end. During this reading, we did not get into the subtleties of comparing different characters or their different perspectives, or details about all the different pictures. Instead, we made it start to finish through a story that suited his needs, taking turns turning the page and sequencing basic events, all the while keeping attention and engagement throughout at least 15 pages. This was a delightful step of progress, but little did I know how this impulsively grabbed book would change our course of speech-language therapy.
Each day in subsequent sessions, this student came in and asked “where’s The Popcorn Book.” Each time we took it out, we were able to expand and interpret different aspects of the story. For example, one day we focused on the feelings of characters in the pet shop (some happy and some mad) while the problem in the book developed (i.e., popcorn filled the store). With each of these characters, we were able to discuss ‘why’ they each had different perspectives (i.e., adults versus kids). On another day, we were able to build vocabulary and discuss all of the community workers found in the book and on “main street,” which was where the popcorn shop was located. On another day, we discussed ‘why’ is it a problem if the firefighter has popcorn coming out of the hose! Oh no!!
One of our goals initially had been to expand play. This student had significant difficulty participating in pretend play, instead frequently lining up and perseverating on cars without awareness of the clinician as a play partner. However, with this storyline now very familiar to him, he was able to share joint attention toward building a simulated ‘Main Street’ play scene. This scene took several sessions to develop, but this student recently asked “where are the people?” which is a great step toward role-playing and creating dialogue during play. This is a necessary step is social communication development and one that I was thrilled to see this child take.
Regarding generalization, this child’s mother noted on multiple occasions that between sessions, while the family was doing their routine errands, he commented on items that related to ‘Main Street’ such as a delivery truck, different stores, community workers etc. As this activity had become meaningful to him, he related other parts of his world to it. This also provided greater opportunity for his mother to have shared focus and conversation with him, building his ability for engagement with others.
While at times it seems messy and difficult to “follow their lead,” if it is done in such a way that facilitates goal-directed conversation and incorporates boundary setting, it can be one of the best ways a child will learn. Stay tuned as we continue exploring this topic and the research behind it in future blogs!
Sandra Kastantin, M.A., CCC-SLP, PROMPT Trained
First photo is the cover of “The Popcorn Shop,” referred to in this blog as “The Popcorn Book.” It shows a woman in an apron using a large popcorn machine.
Second photo is a young boy kneeling and constructing a large pretend “Main Street” on the floor using paper, boxes, and a variety of toys.