Coach Mike
Helping Kids with Autism
Frequently Asked Questions about Coach Mike and Autism
- Why do you enjoy working with kids with autism and other disabilities?
- What makes you think you are an expert?
- How did you start working with kids with disabilities?
- What techniques do you use in working with children with autism?
- Which is better - ABA or the DIR model?
- What experience and education do you have in working with children and adults with autism?
- Who are the foremost experts on autism?
- What causes autism?
- How would we start?
- How do you convey information to the parents?
- How does exercising and playing sports help someone with autism?
- What are the best sports for children with autism?
- How do you supervise a play date with an autistic child and a typically developing child?
- How do you teach empathy to a child with autism?
- How do disparities between receptive and expressive abilities, motor skill problems and sensory integration difficulties relate to delays or deficits in responding to requests by speech or actions?
1.
Why do you enjoy working with kids with autism
and other disabilities?
I do it because it’s fun. I love
the challenge of helping someone be happy, gain
confidence, and make progress. To me, it’s a
privilege and honor to work with children and
adults with disabilities and help them reach
their full potential. It’s a pursuit that is
meaningful, authentic, fulfilling, and highly
enjoyable.
Also, I’ve always loved sports, and I root for
the underdog. Anybody who has played sports or
been a sports fan knows that when someone says
you can’t do something, you love to prove them
wrong. I prefer working with the kids who have
the most severe disabilities because I love the
challenge. One of the things I like most about
working with kids with autism is the amount of
progress that they have the potential to make.
I’ve successfully taught soccer, chess, and
social skills to children with autism in
instances where others were skeptical that it
could be done.
Although I mainly work with kids with autism, I
also work with kids with other disabilities. I
didn’t set out choosing to work solely with
autistic kids; however, there are so many
children with autism these days that that seems
to be the greatest need as well as the greatest
challenge.
2.
What makes you think you are an
expert?
I’m not an expert. I simply
try my hardest and do my best. I have a lot of
experience working with kids with disabilities,
as well as with typically developing children,
but I’m still always learning and I believe that
there’s always room for me to improve. I believe
that many of the lessons learned with kids with
disabilities can be translated to typically
developing kids and vice-versa.
I bring great effort and enthusiasm to my work,
but I also have a calmness and patience that
seems to work well with kids who have autism. If
I feel that there was a session in which I wasn’t
able to help a child, I always analyze and note
what worked, what didn’t work, and consider new
strategies.
It is tough sometimes to make suggestions to
parents who know their kids infinitely better
than I do, and I’m certainly wrong at times, but
I have often been told by parents that it helps
for parents to get the opinion of someone on the
outside, who isn’t as close to the situation.
Without trying new things, you’ll never know what
limits can be pushed.
3.
How did you start working with kids with
disabilities?
My mother was a day care
provider, and that experience had a big influence
on me. Two of the kids had disabilities, and I
played sports with one of them. Throughout most
of my 20s, I didn’t do any work with
children.
Then in May of 1999 I had a chance meeting with
someone who was a volunteer for an organization
called Kids Enjoy Exercise
Now, which provides recreational
opportunities for children (and, at the time,
young adults) with disabilities. She urged me to
volunteer. I’ve always liked working with kids
and playing sports, so this was an activity that
was perfect for me. I was pretty much hooked from
the start, and the whole experience of
volunteering at KEEN was sensational. I joined
the Coaches Committee and was named KEEN
Volunteer of the Year in 2003. I consider myself
lucky to have been a part of KEEN and witness
KEEN expand its programs and launch new
affiliates across the country.
Several years ago, I started working with kids
and adults in their homes, providing a variety of
recreational activities and behavioral
therapies.
I later became a
Job Coach and Assistant Teacher for the Post-High
School students (and a substitute teacher for
students at all age levels) at the Ivymount
School in Rockville, MD, which provides
education for students with serious developmental
delays, learning disabilities, communication
disorders, autism, and/or multiple
disabilities.
In 2006 and 2007, I volunteered as a coach in the
TOP Soccer Adaptive Program run by Montgomery
Soccer and Special Olympics. As with KEEN, the
TOP Soccer Special Olympics program was a
spectacular experience. The culmination of the
season was when the kids carried the flag around
a track to the Olympic music theme. Another
highlight was witnessing the higher functioning
athletes helping the other kids. I had an
incredible time and it was a tremendous pleasure
to be a part of it.
4.
What techniques do you use in working with
children with autism?
There are many therapies
out there and some may work better for some
children than others, since children on the
autism spectrum display such a wide variety of
issues. Like snowflakes, no two children with
autism are exactly alike.
I combine elements of Applied Behavior Analysis
(ABA) as well as the Developmental,
Individual-Difference, Relationship (DIR) based
method. I believe a combination of ABA and DIR
methods is optimal because ABA provides
step-by-step instruction while DIR focuses on
relationships, 
emotions and interests.
Children need both structure and meaning when
they learn.
ABA is used to teach academic, communication,
problem solving, behavioral, social, play, and
other skills by breaking tasks down into small
steps and practicing drills. ABA also uses
positive reinforcement and just as much prompting
as is necessary. Inappropriate behaviors may be
phased out by redirecting to target activities
rather than drawing more attention to those
behaviors. Antecedents, behaviors, and
consequences are tracked to try to determine the
reasons behind behaviors and implement
appropriate interventions. However, some
behaviors may be accommodations children need to
manage their body or sensory difficulties.
Therefore, I focus on building skills more so
than reducing behaviors.
The DIR method focuses on the emotional
development of the child. It takes into account
the child's feelings, relationships and
individual differences. DIR involves following
the child’s lead and enables the child to learn
by doing what he or she likes to do in a fun and
meaningful way. DIR focuses on skills in all developmental areas, including social skills, emotional awareness, cognitive ability, verbal and non-verbal communication, sensory and motor skills, and body awareness.
The DIR method can also
help a child generalize skills initially learned
through drills.
Part of the DIR model includes Floortime, which
is based on working with a child at his or her
current developmental level, and building upon
strengths and interests in a way that is
meaningful to the child, rather than just
focusing on surface behaviors and drills that
don’t always generalize into life skills.
Floortime can be especially effective during
periods when a child needs more play and less
work.
5.
Which is better – ABA or the DIR
model?
In my opinion, this
question is kind of like asking, “Which is better
in football – running the ball or passing the
ball?” or “Which is better in basketball – a zone
defense or man to man?” They’re both necessary in
different situations, and a balance of both may
be most effective. For example, you can do
repetitive drills broken down into small steps
based on the child’s individual differences,
interests and relationships, making sure to
incorporate social skills and emotions.
In doing so, children can learn valuable skills
such as sequencing the steps needed to complete a
task. Children with autism benefit from
structure, but they will be more engaged if the
drill involves something in which they are
emotionally invested. The DIR model is harder to
quantify than ABA, but DIR is built on
relationships, spontaneity and interaction.
Children are not robots, and drills can’t be done
in a vacuum.
For example, you can teach a child who is
obsessed with a particular toy communication and
problem solving skills in the following way: Hide
the toy in one of your hands and get the child to
reach for it and choose which hand it is in. Then
you can do the same thing by holding the toy
behind your back, or placing it near your face to
establish eye contact. Subsequent steps may
include getting the child to make sounds or use
speech if possible to request the toy. The toy is
used as a reward. This example is based on one in
Engaging Autism by Dr. Stanley
Greenspan.
6.
What experience and education do you have in
working with children and adults with
autism?
I have a
Graduate Certificate in Autism and other
Pervasive Developmental Disorders from
Johns Hopkins
University. This is an excellent program and
the faculty is outstanding. I also completed a
course at George
Washington University: Family Support and
Guidance in Special Education. In addition, I
have 10 years experience volunteering with
children and adults with autism and other
disabilities. I have four years experience
providing autism services part-time, and nearly
two years on a full-time basis.
I'm not pursuing a Masters in Special
Education because I'm not interested in
becoming a full-time teacher, although I have
extensive education as a substitute teacher. I
already have a Masters degree (MBA), and I will
continue to get special education training
periodically to update my skills. I work mainly
one-on-one or with two children, because I
believe that is the best way to make the most
progress. There's no substitute for actually
working with the children.
Whatever degree or certification someone has,
keep in mind that there will be people with great
skills and others with poor skills. There are
excellent doctors, and doctors that are
inadequate for your needs, and the same principle
applies for practitioners no matter what the
degree or credential. Unfortunately, autism
doesn't fit neatly into a box, and neither do
its therapies and treatments.
The Board Certified Behavior Analyst (BCBA) is a
worthwhile credential based on ABA. See an
article
describing the BCBA credential. Also see the
Interdisciplinary
Council on Developmental and Learning
Disorders website for information about the
DIR model and Floortime.
The BCBA may be great for certain practitioners
and families, however, my feeling is that the
BCBA is too ABA-intensive for me, so I do what I
believe in and use what I perceive to be a more
well-rounded and effective methodology. I
incorporate the DIR method in addition to ABA
principles, using meaningful reinforcement so
that skills are generalized into the natural
environment.
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Myth #1: If a person with autism cannot speak, it means he or she cannot understand you. |
| Deficits in communication are not necessarily indicative of low intelligence. The ability to understand someone may not always be apparent in people with autism who have poor communication skills. People with autism who have improved communication skills through education and intensive one-on-one therapy have said that they wanted to respond to people when they were younger, but they were unable to for various reasons. Many autistic people receptively understand language more so than they can expressively communicate it. In addition, motor skill delays and sensory integration issues can play major roles in an inability to communicate at desired levels. |
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Myth #2: People with autism are not interested in social interactions. |
| While impairments in social skills go hand-in-hand with autism, it is a myth that people with autism do not desire peer-to-peer relationships. Rather, the neurological processes that result in typically developing children interacting with others and picking up on social cues are not yet developed in children with autism. Children may need guidance and therapy simply to learn how to play with other children. Over time, through therapy and play dates, social skills can be learned to varying degrees. Many people with autism who have adequate communication skills say that they do want friends but that interacting on a social level does not come naturally to them. The same concept applies to feelings – children with autism do experience emotions but rarely express them to the same extent or in the same ways as typically developing children. Understanding and regulating emotions can be learned through practice as well. |
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Myth #3: Nothing can be done to improve the problems experienced by someone with autism. |
| Nothing could be further from the truth. Many children and adults with autism have experienced dramatic improvements in their cognitive, social, and behavioral skills through special education in schools and interventions led by parents and professionals at home. The challenge is finding the right therapy to engage the child in an environment that is optimal for learning and generalizing skills to the real world. The wiring in the brain can continue to be exercised like a muscle. Even though the majority of development occurs early in life, new pathways can always be developed. |
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Myth #4: People with autism have incredible talents in a specific area. |
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The movie "Rain Man" popularized the notion that autistic people are "savants" or geniuses in certain areas. While some people with autism have these unique abilities, it is more common that people with autism may be very proficient or knowledgeable in particular areas because of years of restricted, repetitive and stereotyped patterns of behavior. By identifying and focusing on the strengths of people with autism, the activities and academic areas that resonate with them, and subjects in which they can become truly engaged, we can find windows to the areas that will result in the most progress for cognitive and social learning. If this can be done in a way that allows for spontaneity and creativity in addition to providing structure, autistic people will make great progress. |
Lynn Hamilton says in her book Facing Autism: Giving Parents Reasons for Hope and Guidance for Help, “You will need to initiate the discussion and be persistent in fighting for what your child needs…Don’t give up!..I often urge parents to stop seeing the doctor as the ultimate authority and to start viewing him or her as a member of their board of advisors.”
While at NIH, I suggested to an MD who is one of the experts on autism there that the gluten-free, casein-free diet has improved symptoms to some extent for a certain subset of children with autism. This diet involves avoiding proteins found in wheat and milk, to which some autistic children – usually those with digestive problems – may be allergic or sensitive. This person said, “Yes, but that’s only according to the parents.”
I found this response to be offensive and dismissive because, regardless of the subject matter, it implies that someone who spends an hour every six months with a child knows more about that child than a parent who spends 365 days a year with that child. The statement doubts the veracity of accounts told by the parents. I only mention this because, unfortunately, this is the attitude that many medical professionals hold. Many doctors and researchers don’t seem to know much about people, judging by these types of attitudes. At the same time, there are many outstanding, compassionate doctors who are on the forefront of effective autism treatments.
8.
What causes autism?
Most experts agree that
autism is caused by a combination of a genetic
susceptibility or predisposition followed by some
type of trigger[1] or triggers, such as
environmental factors. However, any more
information would be outside the scope of this
website.
9.
How would we start?
First, I would meet with one or both of the
parents to discuss your goals for your child and
to see if we mutually agree that it would be a
good fit. The first session with the child can
take place right after the meeting with the
parents, or at a later date. The first session
with the child is free so that the parents can be
sure it would be a good fit. You would interview
me to determine whether I can provide what you’re
looking for for your child. At the same time, I
need to know that your goals are compatible with
mine.
10.
How do you convey information to the
parents?
Information can be conveyed
in person before or after sessions, during status
meetings or through e-mail. I believe that status
meetings with parents and any other therapists or
practitioners can be very useful to discuss any
strategies, goals, or suggestions. The parents
need to be on board with the practitioner’s plan
and vice-versa. These meetings are an important
part of determining what works, what doesn’t
work, and which interventions to implement.
Parents must be in agreement on the major aspects
of what will be done, otherwise it’s similar to
trying to accomplish a project without management
support.
I believe when you are talking about the child,
it should be done out of his or her earshot as
much as possible, because many children
receptively understand language more so than they
can expressively communicate. It can be very
frustrating and also deflating to hear someone
discuss your limitations right in front of you,
every day, for many years. It can become
self-fulfilling. Many people with autism have
said that they do not like to be talked about in
front of them.
Think of the example of the person who never
sings, who says that early in life someone said
she was a terrible singer. She never forgot that
statement, and therefore she didn’t try anymore.
Compounding the problem is that some autistic
individuals have excellent hearing, may actually
hear some sounds louder than the rest of the
general population, and in some cases, have
excellent capacities to remember – so if you’re
talking about someone in front of him or her,
think twice about what you say.
11.
How does exercising and playing sports help
someone with autism?
Exercise and sports are
fun, give kids confidence, and improve social
skills. Exercise can also increase attention span
and reduce aggressive tendencies.
Sports and exercise are underrated and
underutilized therapies for improving the
symptoms of children with developmental
disorders, deficits or delays. They can help
children improve muscle tone and lose weight, two
common problems for autistic children, especially
those who are affected by side effects of
medication.
Exercises and stretches that have their roots
based in yoga can help children become calm,
focused and balanced. Exercise also gets more
oxygen to the brain, reduces stress and improves
sleep.
12.
What are the best sports for children with
autism?
This is a hard question to
answer because of the wide variety of differences
in the problems that children with autism face.
Swimming often calms children with autism because
it can balance some of their sensory integration
issues. Bowling is simple and easy, although the
sound of the pins falling down may be stimulating
to some kids and distracting to others. The
weight of the ball can also provide kids with
sensory input. Being pushed in a swing or jumping
on a trampoline seems to work for a lot of kids
because it gives them a sense of where their
bodies end, which is a problem with kids who have
sensory integration issues.
Soccer is the most basic team sport although some
kids lack the aggressiveness necessary to
participate in a game. Basketball is ok, but more
shooting baskets than playing a game, and often
with a short hoop and/or a smaller than
regulation size ball. Badminton can work because
of the lightness of the racket.
The bottom line is that different sports and
exercises will work with different kids, and
you’ll never know which ones are best until you
try. Stretching and yoga-based exercises can calm
a child and ultimately increase attention
span.
13.
How do you supervise a play date with an autistic
child and a typically developing
child?
You have to make it easy
enough for the child with autism, yet challenging
enough for the typically developing child, and
fun for both of them. You need to explain to the
typically developing child that “Johnny doesn’t
always understand how to play, so you need to
help him out. He wants to have fun but doesn’t
always know the rules, so talk to him and give
him a high five.” Younger typically developing
children can also be paired with children with
autism.
With two children with autism, you can’t judge a
play date the same way you would with typically
developing children. Simply being in the room and
coexisting together can be a start. Kids need to
learn social skills somewhere. As long as there
is no aggressive behavior, two children with
autism can learn social skills together.
14.
How do you teach empathy to a child with
autism?
It is well known that many
children with autism have problems with
regulating their emotions. What isn’t as well
known is that many children with autism do feel
emotions strongly. However, they just don’t have
the ability to understand, regulate or express
emotions as well as typically developing
children. This is all the more reason to work on
it. For example, if a tennis player has a
backhand that is the least effective part of his
or her game, you work on that skill because it’s
the one that is needed most – you don’t ignore it
because it’s the worst shot. Children must first
understand their own emotions before they can
relate to the emotions of others. For example,
you can tell them, “It’s ok to be upset.
Everybody gets upset. It’s ok to be angry.
Everybody gets angry.”
15.
How do disparities between receptive and
expressive abilities, motor skill problems and
sensory integration difficulties relate to delays
or deficits in responding to requests by speech
or actions?
Many kids and adults with
autism are mistakenly believed to have lower
cognitive skills than they actually possess, but
certain problems may prevent them from expressing
their level of understanding. In other words,
many children and adults with developmental
disabilities may understand a request and want to
carry it out, but sometimes are unable to do
so.
Many people wrongly assume that autistic people
do not understand how to do something or are
unwilling to perform a task, when, in fact, many
autistic children report feeling “stuck” within
their bodies, and not able to feel their limbs in
order to comply with requests. Research shows
that, at some point there may be a disconnect
between the signals that originate in the brain
and end in the hands, arms and legs explaining
this feeling of being “stuck” within their
bodies.
Many children with autism also have sensory
integration issues. For example, they may be able
to hear fine and see at a normal level, however,
accomplishing both of these tasks at the same
time can be difficult. They may experience senses
that are out of balance – the sense of hearing
may actually be very acute, for example, while
the vestibular (balance) and proprioceptive
(position) senses may be off, which can make
responding hard because of distractions.
My friend Chammi Rajapatirana (pictured above) was featured in the May 7, 2006 issue of Time Magazine because of his use of facilitated communication (FC). I’ve witnessed him communicate through FC each of the more than 100 times that I saw him. Chammi’s friends Sue Rubin and Jaime Burke also use FC.
[1]Definition of “trigger” from www.dictionary.com: Anything, as an act or event, that serves as a stimulus and initiates or precipitates a reaction or series of reactions.