Increasing Engagement through Novel Experiences
Establishing meaningful emotional and physical engagement is difficult for children and adults with autism. The introduction of novelty into daily routines can increase sensory and cognitive awareness and thus increase the chances of being more connected to people and what is going on in their environment. The result of cognitive and emotional relatedness is increased social and emotional intelligence.
Impediments to Creating Engagement
Factors that contribute to problems establishing engagement are, 1) the “Theory of Mind” deficit (a lack of understanding of people as thinking, feeling beings), 2) a hyper-focus on the self or one aspect of an activity or experience, 3) social and language deficits, and 4) sensory processing difficulties. These issues challenge the autistic child’s ability to focus on what is happening around them and thus limiting their ability to relate to others and participate in meaningful interactions.
The engagement deficit, in turn, becomes more pronounced when situations become rote and predictable. These kinds of patterns can be helpful to autistic children, when orienting them to a new system or new environment. However, the patterns are difficult to break and often create a low arousal state so that children lazily go through the motions of behavior with low affect and minimal engagement. Therefore, it is helpful to vary patterns as a way of heightening the child’s awareness and interest.
Although behavioral change is an important goal in the treatment of autistic children, developmental psychologists are less focused on performance and task completion and more focused on emotional engagement and cognitive awareness. Long term change relies on the child having more of an understanding of themselves and their environment and an increased awareness of their feelings and the feelings of others.
The Introduction Novelty into an Established System
Dr. Arnold Miller, a developmental psychologist who developed “The Miller Method” for treating children with autism, uses novelty to create more engagement in the children he treats. Dr. Miller uses simple, functional systems in his approach. He refers to a system as being “any organized behavior in which a child engages.” There are simple, repetitive systems like flicking light switches on and off, and there are more complicated systems, like pouring a glass of water for several people and delivering the water directly to the people who are participating in the system. The Miller Method sees all such systems as opportunities to teach cognitive, language and social skills. It emphasizes the importance of developing systems which have salient properties that awaken the senses and create an increase in focus and awareness. The use of novelty contains the element of surprise which assists in heightening the senses, and for that reason the Miller Method uses novelty as a way of “awakening” children who can be disorganized and scattered, ritually driven, or disconnected from their bodies.
Examples of utilizing novelty to engage a child in a meaningful way with a simple system such as flicking lights on and off would be altering the light switch by making it harder to move, attaching some kind of music or noise to it, or simply changing the color of the light bulb. Most children will notice those differences, and react in some way that creates an opportunity for engagement with another person. A verbal child might ask “Did you notice that?”, or “What happened?” A non-verbal child might look to another person for help, laugh or even get upset. Whatever the reaction to the introduction of novelty, the heightened sensory awareness is an opportunity to engage in an interaction which would not have otherwise occurred within the existing sameness of the system.
Creating Novel Situations
Expanding the world of an autistic child by introducing new experiences helps the child reach their developmental potential because they are forced to think and focus more intensely on what is happening. Although routine may be comforting for these children and their families, the child must rely on adults to expose him or her to new experiences, as well as to variations on familiar situations. The changes can be simple, like walking a different way to school, or more complex in nature like rearranging all the furniture in the house. Another important change is to add new people and new activities to the child’s life on a regular basis. The children do not usually ask for change because many autistic children are context bound, in-the-moment thinkers, and seldom create expansions of activities on their own. They often have limited thinking in the areas of imagination, prediction and interpretation. They may talk about activities and people in exactly the same way every time. Staying at that level of communication limits the development of reciprocal and meaningful relationships.
It is imperative, therefore, to take children with autism to new situations and to introduce them to new patterns of organized behaviors. Doing so creates the opportunity for new language, new feelings, new thoughts and increases interactions with people. Once involved in the novel situation, there is opportunity to notice 1) what stimuli the child reacts to, 2) what those reactions are and 3) how they engage with people while experiencing an increase in their arousal and awareness levels. The information gained from these observations leads to creative, new ideas for approaching treatment in the home, school and community. Adjustments to strategies are made in reaction to how the child tolerates what is being introduced to them.
The Use of Novelty to Reduce Disruptive Behaviors
Children with autism can become stuck in rigid, problematic behavior patterns and must rely on those who help them to break those patterns. Behaviors such as tantrums, resistance to instruction, or difficulty completing simple tasks are common behaviors that benefit from the use of novelty.
Several years ago my son began exhibiting a behavior pattern of “freezing up.” He became unable to use his body in familiar ways to complete activities he had been used to doing for years. He would freeze while exiting a car, leaving a room, putting on his clothes or eating. After many assessments and opinions from a variety of medical and psychological professionals, we were told these behaviors could be called “catatonia related episodes”, with severe apraxia and with no clear origin. My son was twelve at the time these behaviors occurred. We were relatedly told that research was finding some autistic boys during puberty were developing this behavior pattern, but the cause was unknown.
After an extensive round of medical diagnostic tests which ruled out any neurological abnormalities, we were left with confusion about what to do. We decided to go back to the basics of the Miller Method to help my son by reawakening his senses so could regain a connection to his own body. We believed that doing so would remind him about how to use his body properly and keep it in motion so he could complete behavior sequences and simple tasks.
We began by using creative, novel interventions. Some examples of our novel strategies were 1) singing the requests we were making of him, 2) writing down the requests on cards and having him read them out loud, 3) telling him “not” to do the requested action, 4) taking his shoes off, 5) introducing unrelated objects to the situation, having him engage with that object and then making the original request of him again, 6) ringing a bell and 7) playing marching music (Dr. Miller’s fun and creative idea for awakening his feet). All of these approaches worked for a time, and then would stop working because they were no longer novel. We continued to come up with new ideas that would “pull” at his senses and get him moving, and all novel strategies continued to work.
Every child is different and will respond to the use of novelty in unique ways. However, I assure you there will be a response in most cases. The goal is to reawaken sensory and body awareness so integration of the two can occur, with the brain and body once again effectively working together. Whether in extreme cases of regression, like my son’s ( who is recovered now from the catatonia), or with milder forms of social withdrawal or under-reactivity to environmental stimuli, the use of novelty should always be considered as an approach to reach into the often shut down and confused body and mind of the child with autism. The use of novelty will help interject a new level of creativity, challenge and fun into clinical treatment and daily living situations, and create the possibility of long-term gains in all areas of the child’s functioning.
© Rebecca Sperber, M.S., MFT
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