26 Ways to Encourage Communication for an Adult with Autism

Adult Autism: Encourage Communication

6/26/2015

Photo credit: juanedc via flickr

There are so many books and resources geared toward children on the Autism Spectrum, but *gasp*, guess what? They grow up. I know, I know, that sounds incredible, but it's true. A child with autism will one day be a 40 year old with autism. I want to provide ideas that address this gap in resources.

My last post discussed the principles I use in my office to encourage language and communication with children on the Autism Spectrum. These same ideas can be adapted for young adults on the Spectrum, as well as older individuals with Autism who might have difficulty with conversation, language and social interaction.

DISCLAIMER: I am not affliated with the authors or websites mentioned here and have received no form of compensation to mention them.

Where to Start

Here is a review of the basic principles, I use in my office, based on Play To Talk by Dr. James MacDonald and Dr. Pam Stoika, and Greenspan's Floortime and DIR therapy.

Be balanced. Take turns and remember any safe behavior counts.
Be matched. Behave in ways your child can copy.
Be responsive. Respond to both verbal and nonverbal behavior.
Share control. Make sure you both get a chance to choose the topic/activity.
Be playful and affirming. Keep the interaction relaxed, fun, and enjoyable.

These 5 strategies are taken directly from Play To Talk (MacDonald & Stoika, 2007). My last post reviews these strategies more thoroughly.

Adapting Floortime® Strategies for Adults

If music is of particular interest, try listening to favorite songs or pieces and drumming along. You can get a small drum pad for around $25 and practice keeping rhythm with drumsticks or tapping with your fingers.
You can also try humming tunes that he or she seems to enjoy.
Xylophones and small pianos, even if they are toys, can be a fun way to explore music and sounds.
Try making music with water in various glasses.
YouTube is a common interest; however, it is easy for this to be distracting from interaction, instead of encouraging it. So, use this idea with caution. Sometimes exploring videos of a special interest can be useful, try extending into some other activity. For example, watch videos about animals and then use animal figures to act out the video.
See if you can help them create a video of their own for YouTube.
Try looking at magazines that relate to his or her special interest. This can be a good activity for older individuals, as magazines are less likely to seem childish.
Reading books together that interest them, but focus on pictures in the book and pointing out things that are happening or things you see, instead of quizzing, asking questions or just "reading to" them.
For books try encyclopedias or National Geographic. One client of mine really liked field guides. National Geographic also has several publications geared at younger ages, so the reading is easier, but not so childish as a picture book might seem to young adult.
Coffee table books are another great way to engage an adult. One of the favorite books in my waiting room is a Lego book, like this one.
If your adult likes super hero movies or comics, Graphic Novels can be a great way to encourage reading, since they are not straight text. You can also find figurines of their favorite characters and act out the stories together.
Audiobooks can be a great way to "read" together. You can later narrate parts of the story, and wait for a response. This won't work for everyone, since many on the Spectrum become overwhelmed with too much auditory stimulation, but it is worth consideration.
Fidgets, brain teaser puzzles and other desktop toys are often a hit in my office. With some of these items you can try taking turns or building something, if that's not possible you can start by handing the pieces back and forth.
Lego® Architecture sets are a little more, um, mature? And can be a great way to build something together. You could extend this by looking up the original building on Google Earth or Google Maps, by watching YouTube Videos about the building, etc.
Try making a funny face and waiting for a reaction. As always, keep the interaction positive. If things become stressful, back off a little and reevaluate.
As I mentioned earlier, sensory strategies are great for adults as well. Try sensory swings (make sure to use swings that are properly installed and built to safely handle the weight of the user in mind). Dr. Tobing-Puente suggests that this can help them regulate and encourage communication.
Soft and fuzzy pillows or blankets can be soothing. Explore other textures and comment on them.
Almost everyone in my office loves Kinetic Sand. Super fun activity that just oozes with opportunity to engage and interact. I've seen it in many stores now, Target, Michael's, JoAnn Fabric, WalMart, under various names.
If they enjoy being touched, try rubbing lotion on their hands and then let them rub lotion on your hands (I have parents do this with the adult in my office or at home). You can also try brushing each other's hair, as long as this is not a stressful or painful activity. (In that case, well, then, don't ;)
My favorite suggestion from Dr. Tobing-Puente is to use Air Hockey! Here's what she said, "I have found air hockey to be great for using Floortime® strategies such as playful obstruction and playing dumb. For example, pausing and waiting for the adult to ask to 'serve' the puck or playing dumb by putting the puck in your pocket can promote novel communication and expand circles of communication."
Try playing board games in ways that fully include everyone. This might mean playing a game with fewer rules (card games, like Uno or War, checkers) or adapting the rules (as in stacking Jenga blocks and knocking it over, instead of building the tower and pulling the blocks out).
She also mentioned playing basketball as a good activity. I like kicking a soccer ball back and forth, shooting hoops on a back-of-the-door hoop, and playing catch to be good ideas.
Try taking walks and pointing out what you see, make sure to wait for a response. This is really fun at the Norfolk Botanical Gardens here in Hampton Roads.
Try misusing an object, Play To Talk mentions a favorite strategy of Dr. Jim's is to ask for the person's shoe, put it on his head and sneeze it off. This will undoubtedly get some kind of reaction!
If the adult is nonverbal, try imitating or mimicking sounds they might make. Eventually you can make a sound and they will mimic it, too! This can be a perfect way to begin the circle of communication.
Try reading a well-loved book and leaving off the end of a line or important word, wait for them to fill it in, or if they are nonverbal, wait for them to prompt you to continue.

So, my next purchase will be a small air hockey table for the office! :) I would love to hear your ideas in the comments. I'm always looking for ways to build better relationships with kids and adults with autism.

Adapting Floortime® Strategies for Adults With Autism

I am often trying to come up with creative ways to adapt these strategies for young adults on the Autism Spectrum, since there are far fewer resources for adults. So, I reached out to Dr. Lauren Tobing-Puente, a licensed psychologist in New York, who also uses Floortime strategies. She had some interesting ideas that I included in the list.

First, start with the person's special interests. Whatever that might be, Lego® bricks, trains, Dr. Who, birds, insects, lining things up, organizing by color, these special interests will provide the easiest way "doorway" into their world. Don't stress over whether or not it is age-appropriate, since your goal is to increase back-and-forth turn-taking and communication. Avoid teaching the "right" way to play, as this tends to make the interaction less fun and lead to less communication.

Dr. Tobing-Puente encourages parents to pay close attention to special interests and what the person finds interesting right now. She also mentioned that if they are initiating verbally, then it is ok to respond verbally. If they seem overstimulated or frustrated, trying toning down, using less speech, and responding more with nonverbal interactions.

She also mentioned that sensory-based activities are just as important for young adults, as they are for children; since, many adults have difficulties with sensory processing.

While, it might seem easier to apply these "play" strategies to younger children, since their interests and toys seem more natural to play with, a little "outside the box" thinking will give you plenty of ideas.