Making the Most of Early Intervention during COVID-19    

Prior To Your Session

• Write notes – Have questions/concerns/successes written down to address with your therapist. (e.g., Let your therapist know if your child has met any new milestones/accomplishments, any new struggles, what recommended strategies did and didn’t work). Discuss what skills you feel are needed for your toddler and family to be more successful during this difficult time.
• Prepare the space – It will be helpful for you to have arranged a well-lit, quiet space either at a table or on the floor.You may also choose to have sessions focus on your typical daily routines (mealtime, bath time, transitions, etc.). Be sure to set up your computer or phone device toward your work area so your therapist can see and hear these interactions. This helps your therapist give verbal feedback and guidance.
• Get ready to have fun – Make a list of your child’s highly motivating items to include during your session. Doing so may increase his/her motivation to participate. Keep these toys or household objects near you to try some of the tasks your therapist may ask you to do (e.g., stacking a few blocks, picture cards for object identification, toys to promote pretend play, and/or looking at a board book together).

During Your Session

• Getting started – Your practitioner will introduce and model activities, show you strategies to use, and ask you to try it while coaching you through the steps.
• Coaching – Your providers will use coaching/consultation while you interact with your child in ways that support his/her learning and development.
• Troubleshooting – If your child is not cooperating during the session, your practitioner will likely want to give ideas and/or teach you strategies to help you with any behavioral issues in the moment. Be open to rolling with the punches and be gentle with yourself. While these sessions may be difficult, they can also be helpful. Live, positive feedback in the moment creates more opportunities for behavior change, which means more success for your child.
• Siblings – Many parents are home with other children. Siblings are a part of your child’s natural environment; the therapist may want to involve siblings and other family members in the session.

At the End of the Session

• You and your provider will come up with a plan together that details what you want to try with your child in between sessions and small goals to work toward. The strategies your early intervention provider suggest should be simple and realistic for you and your family to implement during the current situation you’re facing. If the strategies are too complicated or aren’t practical to implement in your daily routine, speak to your provider on finding more doable child and family outcomes and strategies.

Attending to the Environment

Preverbal skills are linked to an increase in language development and better social outcomes.

• Responding to their name – Work on responding to name by calling your child’s name 3-5 or 5-10 feet away several times throughout the day, praise them for responding (e.g., “Good looking at me!”)
• Eye contact – Try being at your child’s eye level during social and play interactions and when they look at or reach for an item… don’t let them grab it. Bring that item to your eye level and try to have your child look at you first. (e.g., If your child is looking at the bubbles, bring the bubbles to your eye level while saying, “Bubbles!”).
• Joint attention – Use positive, exaggerated affect when looking, sharing, pointing, or showing items/people in the environment to promote your child’s joint attention (eye-gazing shifting). When you look at/point to an item, wait for your child to look at the same item with you to share the experience.

Language Development

Whatever your child’s primary communication system (expressive, vocalization (sounds or words), sign language, PECS, or a device), you can promote language development throughout daily routines.

• Model – Before giving your child items they want, model the appropriate communicative response, pause, and let them try to repeat what you did before giving it to them. (e.g., If eating apples and looking for another slice, you would say “More apples” and pause (3-5 seconds) to see if they try to imitate you).
• Label – Label items your child wants 2 or 3 times as you give them to him/her.
• Point – Help your child point and touch items that he/she wants as you label it for them. This builds a “functional point” which is helpful for children who have limited vocal communication.
• Pair – Pair single words/2-word phrases to help your child use more words to label everyday items in their environment, including for basic feelings.  Expand on what your child says by adding words to show different concepts (e.g., The car goes FAST!” or “The monster is SAD”)
• Give choices – Work on choice making to promote language development. Try offering your toddler the option to choose between specified foods, items, and activities. (e.g. “Should we play with blocks or read a book?)

*For children with limited pre-linguistic skills, consider the use of gestures (signs) or pictures to aide expressive communication development. Always pair the vocal word with the sign and or picture.

Receptive Language

Use this time to help your child follow directions at home and improve their listening and compliance skills.

• Model the instruction– When giving a 1-or-2 step direction to your child, show your toddler what to do (provide a model) first, and then let your toddler try to demonstrate what you did. Help them as they problem solve so you can provide feedback. (e.g., “Walk this way, and put your shoes in the basket.”)
• Explain in simple terms – Explain rules and expectations in simple language while pairing with a gesture (e.g., “Come here” while pairing a gestural wave, or “Please sit here and wait” while pointing to the chair.)

Appropriate Play

If your toddler frequently engages in inappropriate play and/or the misuse of toys or leisure items (e.g., throwing or breaking toys, jumping on furniture, using toys in a nonfunctional way), now is a good time to work on functional play and leisure time.

• Model – Model single words and simple play actions to help your child imitate basic actions and sounds. Get your toddler involved in play, pause, and see if they imitate your play actions and/or properly elaborate on your play theme (e.g., Use blocks to represent pretend pizza, and pretend to eat it while saying, “Yummy!”)
• Focus on social skills – Work on sharing, turn taking, and working together as a family on a specific play theme or art project which promotes cooperation.
• Focus on language development – Work on item identification and object function during playtime using dolls, trains, farms, etc. (e.g., “Can you feed the baby?” “Show me the one you eat,” “Show me the one that goes, “choo choo” etc.)

Tantrums and Non-Compliance

For a child with autism who has limited communication skills, he or she may become easily frustrated when they cannot clearly express themselves, often leading to tantrums. This is your child’s way of expressing something they need/want or saying “no,” “I don’t want to,” “I don’t know how to do it,” or “not now” to a request.

• Positively reinforce – Ask your provider for education on the principles of reinforcement. Provide positive reinforcement for good behavior and/or communication attempts. (e.g., Your toddler asks nicely to be picked up…you pick them up vs. screaming and getting picked up.)
• Give behavior-specific praise – Provide behavior-specific, descriptive praise when your toddler is demonstrating a desired behavior. (e.g., “Good waiting your turn!” instead of “Good job”).
• Redirect – When your toddler seems disengaged with a task or toy, try to redirect/refocus your child to another activity. Example: If looking off during puzzle play, try to have them do one more piece, praise the completion, and suggest a new activity to do. (e.g., “Let’s do one more, then all done!”)
• Teach appropriate alternatives – Promote alternative behaviors to functionally replace the challenging behavior (e.g., Instead of grabbing brother’s hand or clothes, model for your child a way for requesting for attention appropriately.) Speak with your provider for function-based, individualized strategies to teach your child communication responses for requesting for help, attention, or to access preferred items/activities.