Initiations and Interactions: Early Intervention Techniques for Children with Autism Spectrum Disorders

Author: Teresa A. Cardon
Publishing Info: Paperback / 2007
Reviewed by Maureen Bennie: Director, Autism Awareness Centre Inc.

Parents of children with a recent diagnosis of autism spectrum disorder (ASD) often feel overwhelmed, scared and anxious. Early intervention is the key to aid in the development of these children and for providing support for families dealing with a child’s social, communication, and behavioral problems. Lengthy waiting lists for services or a lack of full services in rural areas can leave parents feeling helpless and unable to meet their child’s needs.

Teresa Cardon, speech pathologist, empowers parents in her newest book Initiations and Interactions: Early Intervention Techniques for Children with Autism Spectrum Disorders. This accessible book is filled with helpful strategies for working with a young child with ASD, helps parents become active partners in therapy, and makes the most of the day’s teachable moments.

Ms. Cardon begins with laying the groundwork for successful communication – helping the child become and initiator rather than a responder. Parents are given ideas through simple tools to increase initiation. These tools are Picture Exchange Communication System (PECS), allowing adequate response time, and using Cardon’s Watch and Wait principal which involves hand over hand prompts and partial modeling from the parent. Parents learn quickly that cuing “wait” through raising an eyebrow can be an effective communicative gesture.

Ms. Cardon shows us simple ways to organize the home to create an environment for communication. By placing things out of reach, locking cabinets, or putting a favorite snack in a glass jar sets the stage for the child requesting help from an adult. Changes to the home to increase requests from a child are simple, quick and often just involve rearranging familiar, desired objects.

Practical advice like focus on the interaction and not the activity are great guides for parents and therapists. Observe the child’s interest level, eye contact, emotional regulation, and requests – in other words what is occurring during the activity. Ms. Cardon gives ideas on how to turn sensory activities into interactions. Every child will have sensory issues and rather than fight them, go with them and create a positive interaction. Incorporating music into movement, daily activities, teaching new concepts and language concepts is also effectively explored. Ms. Cardon’s examples use simple, well-known tunes with word substitutions. One does not have to be a musician to use simple songs and actions to make learning meaningful and memorable.

Books are an inexpensive interactive teaching tool. The types of books and stages of exploration are great guidelines for increasing a child’s interest. Too often parents jump to the “reading the book” stage when the child may only be on the “quick flip” stage which is flipping through a book in seconds. Ms. Cardon shows us how to use each stage effectively and how to maximize present skill levels for interaction. She includes wonderful ideas on how to create additional visual supports for a book through the use of internet resources. Ms. Cardon does the same things with toys as she does with books – divides them into types then provides strategies on how to use these toys for increased communication.

A chapter is dedicated to visual supports – why use them, where to find them, their hierarchy, and supports for receptive and expressive language. There are pictorial examples of visuals and demonstrations on how to use them effectively.

Throughout this book, Ms.Cardon cites many of the best therapists in the autism world such as Dr. Barry Prizant, Dr. Pamela Wolfberg, Carol Gray, and the Koegels to name a few. She mentions great resources and systems developed by people in the autism field such as The Incredible 5 Point Scale by Kari Dunn Buron and Tasks Galore by Pat Fennell, Laurie Eckenrode and Kathy Hearsay. Ms. Cardon’s approach to the initiation of interaction is the tried and true methods of those who have work with children with ASD over the past three decades. The book is also peppered with information bubbles – sidebars of ideas that enhance concepts described in the text.

Parents will feel empowered to work with their child through this well organized, resource supported book. Most of the ideas use materials already found in the home or inexpensive dollar store items, internet resources, and items found at your local library. Therapists will also find this a great teaching tool for parents and increase their own arsenal of at-home therapy ideas. Initiations and Interactions: Early Intervention Techniques for Children with Autism Spectrum Disorders is a great place to start to lay the groundwork for positive interaction and initiating communication between the child and parent.