A friend has published a practical resource for developing play and communication skills in children on the Autism Spectrum. Ruth Harris, along with two colleagues, has written Teach Me with Pictures. It’s a book of picture scripts that are ready to use – you can photocopy them or print them from a CD-ROM. Ruth has been working on the book for a while; she spoke about it at the initial Therapy Ideas Live event back in July 2011. Congratulations Ruth, Simone and Linda, it’s wonderful!

The book begins with an introductory chapter, explaining what picture scripts are, their benefits and how to use them.

So what are picture scripts?

You know the picture instructions that come with flat-pack furniture from places like Ikea? They’re picture scripts. You follow the pictures step-by-step, breaking up a complex task into manageable pieces.

Next the book explains why picture scripts work so well for children with Autism. Get the book and read this chapter, it’s insightful, easy to follow and will help you explain the approach to parents and teachers. Many children with Autism are visual learners, who respond well to predictable and achievable activities – picture scripts are perfect. After discussing the skills picture scripts can promote, the book describes in detail how to use the scripts, so you’re ready to get started.

What activities do the scripts target?

The 40 picture scripts are divided into categories:

• Pretend play
• Drawing pictures
• Building and construction games
• Cooking
• Arts and Crafts
• Everyday living

You can see an example of some of the scripts on the publisher’s blog. I can’t wait to try making sandwiches and drawing monsters in therapy, I think the kids will love it!

This book could be used by SLTs, teachers, parents and anyone supporting children with language, learning or social communication difficulties. The activities have been designed to reflect what typically developing children of around 6 years old do, so we can teach our clients the skills they need to take part in the same activities as their peers. That said, a couple of the scripts are a little American, making nachos and ice-cream soda? Still, a good communication opportunity – talk about cultural differences!

This book is an inspiring starting point, use these scripts and then make your own. What does your client or child need to learn how to do? Write your own script and help teach them!

I finished running the program for the first time in January and last week I visited the families who’d taken part, to review their progress. So what were the outcomes? All the children had moved forward with their communication; one child listened to a question and responded appropriately by nodding her head, another came up to me and initiated a game by tapping me on the shoulder — they were communicating!

The parents had also made huge, significant changes — they were waiting for their children to communicate, rather than anticipating their needs. They were joining in with activities their children had chosen, rather than trying to re-direct them to activities they’d chosen. I watched one mother notice her son was captivated by sticking pieces of damp paper to the table, and use the intrude strategy to encourage him to indicate he wanted more paper – and it worked!

The parents were overwhelmingly positive about having taken part in the program; they talked about how wonderful it was to meet parents of children with similar needs to their child. They were reassured to learn how to move their children’s communication forward. They noticed small changes and celebrated them.

Why does the program work so well?

• It incorporates what we know about adult learning and changing habits. Hanen’s 4P cycle of prepare, present, practice and personalise engages parents and gets them ready to be successful. A mother commented that although her husband had read the More Than Words book – it just wasn’t the same as attending the sessions.
• It uses video examples during the parent sessions, and video coaching at the home visits, to help the parents see what they’re doing that’s beneficial and identify the next step.
• It uses a group format, which is hugely supportive for parents. Our group was made up of parents who spoke five different languages, they really gelled and it was easy to see how reassuring the group problem solving was.
• The program is intense: we met for seven weekly parent sessions lasting three hours, and four home visits. After Lidcombe therapy, it’s the most intensive intervention package the team offers. It felt like an investment: at the end, parents were so much clearer about what they were trying to achieve, more aware of how their behaviour could support their child, and ready to co-create the therapeutic process.

More Than Words in Private Practice?

This week I’m leaving my NHS post (eek!) and heading out into the world of private practice. I’m trying to figure out how to make More Than Words part of what I offer to parents. I’ll be able to run evening sessions, so working parents could attend, although I’m not sure if logistics-wise I’ll have enough appropriate families on my caseload at the same time, to make up a group. Have you run Hanen programs outside the NHS? How did it work?

If you’re an SLT and would like to attend a More Than Words workshop, Ealing are hosting one from 29 – 31 July 2013, you can register your interest today!