Ways of supporting the emotional and social development of children with autism

Greenspan’s Functional Emotional Developmental Levels

Child development is usually thought of in terms of specific categories e.g. cognitive development, fine motor (hand skill) development, social development. As a mother of 3, with 20 years of therapy training and experience behind me, it is clear that children don’t develop skills in isolation, we need to view the  whole child in their developmental trajectory. Cognitive development will be impacted by physical skills (e.g. understanding ‘object permanence’, knowing that an object still exists despite being out of sight, will be compromised if a child is physically disabled, they can’t physically hide a toy then return to it to see if it is still there……….). Social development may be impacted on by language acquisition, or even physical skills such as balance!

The pioneering work of Dr Stanley Greenspan, Child Psychiatriast, theorist and developmentalist, has made an enormous difference to my understanding of what supports children to develop in a ‘typical’ trajectory. He worked with thousands of children over the course of nearly 40 years, as a clinician and research scientist. He collaborated with many internationally reknowned specialists, medics, therapists, educators, pyschologists, scientists and more, and created the Interdisciplinary Council on Developmental and Learning Disorders (ICDL). He published extensively and synthesised a developmental trajectory which incorporated cognitive, emotional, social, symbolic skills, he called it the ‘Functional Emotional Developmental Scale’. Using this Scale has been pivotal to helping me analyse where I need to target my therapeutic input. As I explain each Capacity to you, I hope you will see how and why development happens in this order, and what happens to children with learning difficulties or autism, when the earlier developmental levels are not robust….

Alongside the Functional Emotional Developmental Scale, Dr Greenspan also broadened his analysis of development to analyse what impact the child’s experience of relationships (e.g. family), their broader environment, their sensory processing (e.g. visual perception or auditory processing), their motor skills and their own biochemistry, might have on the child’s Functional Emotional Developmental path. From this, he, alongside many colleagues, created the Developmental, Individual Difference, Relationship-Based (DIR) Model. This Model is now used in many countries throughout the world. The Model has an expanding tranch of research to support it’s efficacy, especially its use with children who have disorders of relating and communicating, such as autism.

The Scale has been simplified into 9 Levels.The first 6 are described extensively in Greenspan’s books, and also form part of the Bayley Scales of Infant Development, a gold standard assessment of 0-3 year olds used by doctors, psychologists and therapists. I will examine each of the Levels one at a time in my next posts. But first I want to expand on my discussion of those Individual Differences and the Relationship part of the DIR Model…..

Emotional Development

Our ’emotional brain’, the limbic system, is one of the earliest systems in our brain to start developing after birth. Mum’s soothing voice makes baby feel calm and comfortable. They will respond emotionally to mum’s voice as they remember it calming them before. Memories are tagged with an emotion, and, the limbic system is where we store these memories. So the limbic system is fundamental in emotional development and memory.

Now if we see that in early childhood, children are driven mainly by their feelings, then we can understand them better. Joey grabs the biscuit off the table because the last one he ate tasted delicious and have him a yummy, pleasurable feeling. Sandra runs to Uncle George when he visits because she remembers a happy, excited feeling she had last time they played together. Charlie hides from Uncle Jeff because he remembers feeling scared when Uncle Jeff shouted on his last visit. A child’s response is governed by their emotion. Emotions like happiness, excitement, love, motivation, interest, worry, stress, despair, fear, and so on, govern how we respond in situations.

As adults, our higher level brain – the cortex- can over-ride our emotional response. People go to jobs they hate, as logic tells them they need to go so that they will be paid. We don’t eat chocolate cake all day as we are abe to consider the health implications. Our higher brain interacts with our emotional brain and they agree that we’d rather stay healthy, than have the short term satisfaction of the feeling that the yummy chocolate cake gives us! However, even as adults, emotion plays a huge role in channelling our behaviour. Exciting books are easier to read than those we find boring. We will want to be with people who make us feel good in their company. We will be energised in activities which motivate us.

So understanding where children are at in their emotional development will support us in understanding the whole child better. They will always be heavily influenced by their over-riding emotion in any situation, but has their brain sufficiently developed that they can now think logically as well?

As a developmental therapist, I rely heavily on the work of Dr Stanley Greenspan. My next post will be about his Functional Emotional Developmental Scale and how it helps me in my work with children who have autism spectrum disorders.

Play with Emotion!

So here is the beginning of my journey in the blogasphere. I’m starting this blog as I want those in the UK to have access to the great research coming out about treating children with autism and other developmental disorders. My plan is to post research links here and comment on what’s new and what works.

All those working with people with autism spectrum disorders know that each person has a unique profile. Different therapy inputs will support different individuals. Families themselves will have preferred styles, and those need to be taken into account. There is no such thing as one size fits all. So here I will discuss a range of treatments/ inputs which I have seen working. But I will come clean about my biases. When it comes to helping children, my passions are raised and my feelings are strong regarding the direction I feel autism services should be heading. So here are my biases!

  1. Families – The child and family should be at the centre of our work.
  2. Relationships – The child with autism does best in a loving, warm, attuned home, school, club, etc. Nurturing, soothing, joyful interactions are what we all look forward to in our day. We are drawn, emotionally, to the smilely, positive, warm person. Sometimes we shy away from the overly animated ones, or sometimes the very animated people energise us. However we are feeling, being with people who are emotionally attuned with us, support us to feel good in ourselves. We will want to engage with them because the emotional relationship has enticed us!
  3. Neurology/ biochemistry – Don’t be scared off by these terms!! We are all a result of our hereditary make up. Each of us is wired differently. If our wiring lets us down, so that we find it hard to process what we see or hear, or we find it hard to organise our bodies, etc, then we need help to rewire our systems. Also more information is available now about special diets which can support some individuals. I rejoice when dietary intervention works because the child can sometimes make dramatic prorgess very quickly. Medical testing, e.g. for mitochondrial disorders, falls into this category too.
  4. Environment – This links up everything.The child’s physical environment, i.e. the child’s family, extended family, nursery/ school, community, but also the national and international picture. How does government policy impact on the child with special needs and those supporting them?

I would love, over time, for you to let me know about other treatments that you feel work, so that I can learn from you too.