What can I do to help a child who is on a waiting list for assessment?

Answer: When it is suspected that a child has autism, they are often placed on a waiting list for an assessment. The wait can be several months, sometimes longer. In the meantime, parents, grandparents, caregivers and other professionals would like to help that child in any way that they can. There is much that can be done even before an official diagnosis is given. If suspicions turn out to be incorrect, the help given will not have been harmful in any way. Where do you start?

Communication and language development are often the first red flags for seeking an initial assessment. If a child is not speaking or using gestures to communicate needs, a system of communication needs to be developed. Once this is in place, challenging behaviors often decrease.

Develop a communication system by using visual supports. These can be anything from digital photos of familiar objects and routines to pictures. (Note – there is a hierarchy to using visual supports. Start with using actual objects, then move to color photographs). Model how to use these supports. For example, if a child wants a drink of juice, use simple language and say “juice” then have the photo/visual handy and point to it. You can take the child’s hand and place it on the photo and say “juice”. Don’t worry about using complete sentences at this point. You just want to model using the visual with a word and a gesture such as pointing. One helpful website for using visual supports is Do2Learn.

Create situations to increase communication because when a child is having difficulty speaking, they often won’t initiate any interaction. Try placing a favorite item out of reach so that the child has to request it by taking you by the hand or giving you a visual picture of it. (Don’t do this if the child is a climber or fearless and will try to get the object on his own no matter where it is). Put a snack inside a jar so the child has to ask for help to get it out.

It’s never too early to start introducing the concept of time. Even though young children can’t read a clock, they can understand a visual timer like a sand timer. Knowing there is a beginning and end to things decreases anxiety for any child. Other ways to show time can be to create a schedule, then cross off the items or remove the picture as the sequence is being completed.

Play can be a great way to get communication going. Try turn taking games like ball games. Turn taking situations teach patience, waiting, and reciprocity. Great books for finding games to increase attention, interaction, and for structuring play are Playing, Laughing, Learning, Small Steps Forward, and Stepping Out. Books are a great resource for learning about play because as adults, we often forget how to play.

Play will need to be structured if the child lacks imagination, manipulates objects (lines them up or moves them back and forth from one pile to another), or doesn’t include anyone else. You may need to model what to do with a doll and a doll’s house or how to build with blocks.

Sensory integration dysfunction can be another early red flag. Examples of this can be strong aversions to certain fabrics, sensitivity to noise, high or low tolerance to pain or touch, or seeking sensory input by jumping on or running into furniture. The list is quite large on this topic. Observation is key here. Keep a journal on what seems odd about the way the child interacts with the world. Do they hate having their hair washed? Teeth brushed? Need many blankets on to sleep? Can’t stand the seam at the end of a sock? This list of things will give you a sensory profile and a place to start for helping the child soothe the senses. Great books to start with here to learn more – The Out-of-Sync Child or Building Bridges Through Sensory Integration.

Challenging behavior is another reason parents seek a diagnosis. This can be anything from meltdowns, sleep disturbances, rigidity with routines and daily schedule, and odd behaviors such as repetition of a movement or a fixation on an object. Children want predictability and a way to make sense of the world. If the information coming in is not able to be organized, chaos happens. Challenging behaviors can often be addressed through sensory integration, having a communication system in place, and visual supports to put the environment in some kind or order or structure.

None of these suggestions is to take the place of a formal assessment or professional recommendations from a speech pathologist, occupational therapist, psychologist, or any other professional. These are just some ideas to move things forward and help a child improve their skills.