Many children with this kind of problem have been labeled with terms like Pervasive Developmental Disorder (PDD), Autism, or Asperger's Syndrome. We need to ask what is going on with the child instead of labeling him, and we need to try a number of interventions that meet his needs for a substantial amount of time. Labels tend to carry needlessly pessimistic implications. This can cause some teachers and families to feel hopeless about the possibility of growth and change. But hopelessness is not warranted. In fact, when we identify the child who has trouble relating relatively early in his life, we can intervene and often effect great change.
Teachers and parents are understandably concerned about children who seem uninterested in relating to others. Some of these children have little-if any-language, while others are quite verbal. However, all children with this problem tend to avoid two-way communication.
Parents often report first noticing an indifference to other people when their children are between 18 months and 3 years old. This is the period when we expect to see rapidly developing language. If language doesn't come in as expected, parents suspect that something is wrong. Many wonder if it is a hearing problem, but when tests reveal no hearing loss, concern grows about the language delay and the limited efforts the children make to communicate and relate.
When further discussing their child's earlier development, parents may recall that the child hadn't communicated in typical preverbal ways either. Then, as he became a little older, instead of making progress in communicating or relating, the child slipped more and more into his own world. Behaviors include aimlessness, a self-absorbed manner, and an avoidance of contact with others, even other children.
Mechanical vs. Meaningful Talk
All children seek out adults for comfort when they are hurt or in need. A child with a problem relating may do so, too, but the difference is that he will indicate a concrete wish, such as for a door to be opened, but will not be interested in having any sort of complex two-way conversation, either verbally or with gestures.
A child with a problem relating may enter preschool talking, but the talk is mechanical rather than meaningful and not designed to enhance interaction. He may know the words to many songs and rhymes and be able to recite the alphabet and name numbers, but he will not put this information in any particularly relevant context. When another person, child or adult, tries to converse, this child may turn away. Occasionally, the child may use a word or two purposefully, like "juice," but more often what he says doesn't make sense to others, fit the context, or have any social purpose.
Roots of Behavior
If we look back at the beginning of the child's second year, we can often find the roots of this behavior. While children of this age typically guide an adult to a toy area and point to the one they want, or gesture at the refrigerator to communicate a desire for a particular food, these children do not. In order to do those things, a child has to have a wish that is based on a feeling, which directs the action. She needs to know what she wants before she can communicate it, and she then has to be able to connect her feelings with motor planning and other functions of the nervous system. For some as-yet-unknown reason (probably a biological one), children who are not relating and communicating find it very difficult to make these connections.
In some instances, the child's core problem is with motor planning, auditory or visual processing, and/or with connecting any or all of these with feelings and wishes. If he can't plan his movements, he's going to wander aimlessly and line up his toys rather dian use them for purposeful play. If he has problems with short-term auditory memory or can't easily give meaning to the dungs he hears, he is going to be silent, self-absorbed, or recite meaningless syllables or irrelevant words.
Overcoming all of this requires an urgent motivating force: feelings and desires. That's why it's of no value to try to change such a child by having him simply memorize social scripts (for example, learning when to say "hello" or "goodbye" or "good morning"). This won't solve the real problem. If you can get a feeling going, however, the child is very likely to begin interacting with others in a genuinely purposeful way.
What You Can Do
To help most effectively, try the following:
• Seek available early-evaluation and intervention services. A team of experts will do a complete evaluation and plan their intervention with the help of both the teacher and the parent.
• Don't allow the child to spend his time passively, playing alone repetitively with the same toy, or working on rote skills. Instead, the time should be spent in communication with peers and teachers. Plans for enticing these children into such activity should be individualized-geared to each child's level of development and personal desires.
• Place yourself as an obstacle until you can't be ignored. Let's say the child is moving a truck back and forth aimlessly. If you say, "What a nice truck. Where is it going?" the behavior will simply continue. Instead, take a doll or a stuffed animal and, speaking for it, say, "I want to go for a ride in your truck." If the child ignores this, put the doll in front of the truck and say, "I am going to stand in front of your truck unless you give me a ride." The child must choose between moving the truck to avoid knocking the doll over or taking the doll out of the way. (If this doesn't work the first time-if the child stops playing or walks away-don't give up. Working with a child with this problem is often very difficult, and you may need lots of help, support, and time.)
• Build up the child's interest and create more and more interaction. Daily play with peers is also critical. Other children will challenge the child with the kinds of speedy interactions that adults can't do. You might start off with a peer who won't be too competitive or aggressive.
• Use the child's strengths. Follow his lead and capitalize on his wishes. Motivation, after all, is the important missing piece when there are problems in relating. A wish or intent leads to relating and later to abstract thinking.
• If the child is already verbal and capable of doing some imaginative play, you'll want to broaden it. If the child is capable of logical thinking, answering the W questions- Who, What, Why, Where, and When-you'll want to move him toward discussions.
• Try to increase the child's emotional range by challenging her with new emotions. For example, rather than trying to teach a child to name colors, invite her to answer questions such as, "Which color do you like better and why?"
If interventions are tailored to the individual child's existing developmental capacities, many children learn to relate to teachers, parents, and peers with warmth and intimacy-and eventually go on to have rich interpersonal lives.