I Think My Child is Autistic — Early Interventions to do Now (with Kids Four and Under)
Don’t worry parents of older kids awaiting diagnosis, I’ll get to you next. I’d still read this article, though, because these age ranges are just suggestions. If you have an eight year old who still loves to play blocks, you will find useful information here. If you have an extremely sensory-sensitive ten year old, same thing. But since more and more children receive their diagnosis around age four, I wanted to start with that age range. Whatever your child’s age, if you suspect your child has autism you do not have to wait for a diagnosis to start making positive changes in your child’s life to support them and encourage their development. Let’s take a look at some major areas together:
Sensory Regulation
The first area I want you to look at is sensory regulation. Kids with autism often have outsized reactions to things we may not even notice: tags on our clothing, fluorescent lights, and certain pitched noises, to name a few. It will be very hard to help them gain any skills if they are already maxed out dealing with their sensory stressors. Can you imagine having to take a test with strobe lights and someone screaming in your ear? It wouldn’t be very easy, and you’d probably get agitated, to say the least. So keep the sensory environment at the top of your mind when engaging with your autistic child.
The first thing I want you to do is just sit back and observe. Take notes if you have to. What makes your child happy? Unhappy? Contrary to popular opinion, most autistic kids are great at self-regulation if given the proper tools and support.
I realized my own daughter, Emmy,* needed a lovey or a blanket to carry around in public situations. With Elmo in hand, we could make it through Target, weddings, and crowded playgrounds much smoother than without. I’ll admit, ninety degree days when she picked the huge blanket were less than practical, but I’d prefer having to deal with an inanimate (if bulky) blanket than a screaming two year old. Other helpful items may include chewelry,** tag-free clothing (and seamless socks), weighted vests and blankets, and noise-canceling headphones.
Little changes to your child’s space can make a huge difference in regulation, too: A clean house always helps. If you can’t keep the whole house clean, focus on one area: For us it is the living room. Emmy can go chill out on the red couch if she’s feeling overwhelmed. It is clutter-free and quiet, away from the hustle and bustle of the kitchen, and helps her keep her equilibrium. Changes in lighting (more or less of it, depending upon your child), keeping fans on (for those who love moving objects) or off (for those who are noise sensitive) can also help. Again, this is going to depend upon you closely observing your child and responding appropriately.
Language Delay — Meet Them Where They’re At
Once you’ve created a supportive environment for your child, you’ll probably start to see incremental improvements without much more work. But we want more than incremental improvements, we want leaps and bounds! The two big areas most parents worry about are language and social skills. So let’s start with language.
The best way to get your kid to start talking is to play with them! This does not have to be fancy. In fact, it shouldn’t be. Do not waste your resources buying special toys or designing elaborate set ups. Instead, meet them where they’re at. Do they like lining up their toy cars across the bedroom floor? Get down on the floor with them and make some observations. Hand them another car to put in the line. If your child seems amenable, place an obstacle of some sort in front of the line to see if they go around it, over it, or through it. Look at that! You’ve started helping them with prepositions already!
One thing to avoid is quizzing. Do not make them repeat “the block is blue” or ask them over and over what color the block is. That’s not playing, that’s testing. Making simple, open-ended observations such as “my favorite block is the blue block,” opens up the door to a much more meaningful, and, over time, useful, exchange.
A final word on language: As many as 85% of autistic kids are gestalt language learners. That means they learn language from whole to parts instead of parts to whole. So while analytical language learners may progress something like this: “ball” to “want ball” to “I want ball” to “I want the ball, please,” gestalt language learners may start with a script or two (from a movie or show, most often) only tangentially related to wanting the ball, and, over time, break that script down to smaller mix-and-match components. (You can learn all about gestalt language learning at Meaningful Speech.) With gestalt learners, playtime is the perfect time to model useful gestalts, such as “I need a blue block next,” which, over time, gestalt learners can begin to modify over time to make a myriad of requests.
Social Skills
You’ll see a divide in the autistic world on teaching neurotypical social skills to autistic children, so I’ll tell you what I personally believe and you can decide if it aligns with your values: I want my children to be polite, regardless of whatever challenges they may face. I also think some “polite” behaviors are overemphasized in Western society, and I am willing to drop them. Eye contact, for example, is a big one. I do not force Emmy to make eye contact with people. It feels unnatural and unhelpful, and many autistic adults say it’s incredibly uncomfortable, so we let that one slide. I do, however, encourage her to greet people when they say hello to her. Really this hasn’t been any different than with my neurotypical daughter, it’s just taken a little longer to catch on. There is no magic trick here, just repetition, reminding, and modeling.
Social stories can go a long way with helping these skills. This can be as simple as an explanatory sentence in a situation. (“When we see someone we know, we say hello to them.” Then turn to the neighbor and model, “Hello, Mrs. Smith!”) I remind Emmy (and her younger sister, Bee), all the time why we are doing something, and encourage them to engage in the desired behavior.
You can buy (or, if you are so inclined, make) social stories for situations and behaviors as well. Having two young children during Covid, we read several social stories about washing hands and covering our mouths when we sneeze and cough. These short, direct booklets are simple and often sold in a large pack, such as this one** that we have used at home. They need to be read often, and reminders need to be made in practice, but really that is no different from teaching any other child.
I can personally attest to the power of social stories. Being artistically inclined, I made a custom social story for three-year-old Emmy when she was struggling with some separation anxiety at the start of preschool. We read it over the weekend several times, again before school on Monday, and it was like taking a different child through the preschool door that morning — not one single tear!
Normalize Autistic Behavior
Finally, I want to encourage you to embrace non-harmful autistic behaviors. If your child enjoys spinning, let them spin! They are expressing their joy. If your child needs to be holding a lovey when meeting new people, let them hold it! It comes down to a single question for me: Is this behavior harming anyone? If the answer is no, I let it continue. To clarify, I will stop or redirect behavior that is unduly distracting, like screaming during church service. But if people are just staring at Emmy quietly rocking in a church pew, that’s their own problem.
A Final Word
If you are looking to dive deeper into the world of home-led therapy, I’d suggest reading my article on Relationship Development Intervention therapy, with which Emmy had many breakthroughs in communication. Stay tuned for my article on early interventions to do with older kids, as well, because things like Declarative Language and Special Interests are important for kids of all ages. Best of luck to you and your family!
*Names have been changed. **starred links are affiliate — help a mama out!
Annie Newman is a substitute teacher, mom, and aspiring children’s book author raising two children: one neurotypical and one autistic. You can also follow her day-to-day learning on Instagram and on Tiktok.