Autism Games: Come Be With Me

By Tahirh Bushey M.A.C.C.C.
Speech and Language Pathologist

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Tickle or Squish?  Early Reciprocity Games

Reciprocity is where two people intentionally interact, for example when you call your child and your child answers; when your child requests a teddy and you provide that toy; when you give your child something to eat and your child refuses that food; when your child comes in crying and you say, Aw Honey, what happened?

Reciprocity is not easy to establish with children who have ASD.  It can be practiced with words, smiles shared, a questioning look, a responsive shrug, or two people looking at a book together.  All of these things are examples of reciprocity.  One way that reciprocity can begin is for the parent to imitate the child. 

There are systems for starting a relationship

Using games or activities based upon sensory experiences are common to many approaches.  For a further discussion on why and how to start with sensory or motor activities, please read Creating Common Ground.

Games you can bank on

Here are some all-time successful games for encouraging your child to come to you in order to interact.  Playing these games often helps to establish reciprocity with children who otherwise ignore, run away, or avoid interacting.  The first goal is to teach your child some of these games.   Then the goal is to teach your child to request these games or at least willingly and independently come to play these games when you offer the opportunity.

All of these games work exactly the same way. Your child does some pre-taught behavior to initiate and/or continue the game and you respond appropriately. If your child likes to be tickled then your first game might be a Tickle Game. If your child likes to be squished between two pillows, you will show your child a way to ask to be squished and you respond by squishing.

Some other possible games include picking your child up and twirling him or her around, or swinging your child in a blanket (you need two adults to do this) or in a swing where you are standing in front to maintain face to face interaction.

Above, you see a dad creating a predictable pattern (with small variations) that pull his child into an interaction over and over.  If your child is too heavy, use an Swing Game and a predictable verbal interaction.  Any predictable, pleasurable activity will work and you should teach your child to play many of these games as a starting point for social interaction  (see sidebar for game ideas and for more clips that show simple games). Even a dramatic facial expression and funny word that you say each time in response to something your child does may motivate your child to request the game again (see below).

Knock um Down!  Games where you set up blocks (or toys) in a stack or across a table and then you knock them down are nearly irresistable for most children.  The game can, over time become much more complex as you encourage your child to sit for while or help you set blocks up or knock down certain color or size blocks.

Bubbles and balloons

 
Although you need to be very careful about having balloons around young children (never let the balloon out of your sight), a favorite early reciprocity game at our clinic is letting just a little air out of the balloon on the child's hand, foot or tummy.  

The same game can be played with bubbles.  Children will often pull up a shirt or put out a foot to get a repeat of this sensory delight.  Whatever games you choose, soon you will have a request and a response, followed by another request and another response.  That is the makings of reciprocal social play!

Tickle

 
Tickle games are favorites of many children.  They can be used to teach interaction and vocabulary.  Here are two video clips: Animal tickle demonstration and Animal tickle live.

In this game, Mom pretends to be an animal and then tickles her son.  The child request Kitty Tickle in this clip but he has pictures on his communication device that represent Monkey Tickle, Duck Tickle, Doggy Tickle.  His parents use different animal sounds as they tickle their son. These sounds are quiet or loud, fast or slow, depending on the kind of animal they are pretending to be. 

The son can also request to be tickled on his foot, under his arms, or on his tummy.  He requests with his talking device, DynaVox Voice Output Device.  Simple Talking buttons could be used in the same way as this computer device is being used in this game on the clip. 

How can your child request?

• A Look
  Your child can simply look at you, however fleetingly.  That is where I begin with children who tend to move away all the time but suddenly do not move away when I hit upon some sensory activity that is fun.
  If a child looks at me with hope and expectation, I interpret that as a request.  An expectant glance is actually a very good communication signal — we all use this glance a dozen times a day and most children with ASD are not using this signal very often at all.  Any game that increases your child’s propensity to look at you expectantly is a great game.

• A Gesture
  Your child can use a sign or gesture that means tickle (caution: do not use the sign for “more”) or means squish, or twirl or swing even if you have to make up some simple gesture to mean each specific action.  I recommend the signs from Baby Sign Books because these signs are easier to make in terms of motor skills, and if you can’t remember what you did last time, you can look it up in your book. For Tickle, I think that when a child pulls up his or her shirt, this is a pretty clear gesture. 

• A Word 
  Use the word “Tickle” (or another appropriate word) to describe the action in the game.  Say the word over and over each time you do the action.  Your child will associate the word with the action and start to say the word.
  
  You may want to accept a glance or teach a sign at the beginning but keep using words too.

Wait Time

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