Category: autism evaluations

The MIGDAS Diagnostic Student Interview:

Tips for connecting with the child during the evaluation session

When I interview a child as part of an autism evaluation, my main focus is on finding ways to invite the child to share his or her unique way of viewing the world. How does one do this reliably, interview after interview, when every child has a singular set of interests, personality, and style of relating to others?

It helps to prepare by learning about the child’s interests beforehand. Over the years I’ve prepared for interviews by learning a fact or two about a staggeringly diverse range of topics: geography, World of Warcraft, String Theory, NASA programs, Adventurequest, and Sponge Bob Squarepants, to name a few.

Ougadougou is the capital of Burkina Faso; it’s good to be a gnome in World of Warcraft, M Theory is even harder to understand than String Theory, the NASA Mars rovers are named Spirit and Opportunity, you need Z-tokens when you talk to Zorback in Adventurequest, and Sponge Bob frequently tells the world “I’m ready!”

Once you’ve learned a fact or two, it’s important to begin the interview by jumping into the child’s area of interest. Children with autism spectrum differences genuinely enjoy the invitation to share their areas of passion. And yet, most of the time they experience being told that they need to focus their attention elsewhere. The interview works best when it begins with the invitation to explore areas of interest instead of pushing them aside.

Keep the conversation going by subtly mirroring the child’s way of speaking and expressing his or her thoughts. A child with autism spectrum differences responds to this parallel experience by showing signs of relaxation and genuine enjoyment.

You’ll find that in addition to experiencing a shared exchange with the child you will gain a deeper understanding and appreciation of the child’s singular way of interacting with the world. That will in turn lead you to develop individualized and highly effective recommendations to support the child’s skill development in challenging areas.

The MIGDAS Diagnostic Student Interview process provides guidelines to help evaluators set up and participate in successful evaluation interviews with children of all ages. A copy of my “Ten Tips for Evaluation Teams” is available to download from the link below:

MIGDAS_DSI_Ten_Tips_for_Evaluation_Teams_August_2011

Let’s get back to the water toys. The examples of children used in these posts represent composites of the responses of actual children. No identifying information regarding individual children is used; the names and physical descriptions of the children are literary devices.

In my team evaluations with children—anywhere from preschool age to upper elementary age—starting the evaluation session with a water toy on the table works really well.

Peter, a preschooler with a sturdy build, serious demeanor and suspected autism, is nonverbal but enjoys watching children’s animated programs at home. When he entered the evaluation room, the water toy was the only object on the table.

I started my conversation with Peter by pushing the button on the green water ring toss game several times, causing the rings to flutter through the water. His gaze immediately focused on the visual motion and he sat at the table to examine the toy in more detail

By the way, I didn’t start talking until Peter was already engaged in his play with the water toy.

He reached for the base and pushed the button, gaining control over the cause and effect loop. I began to label the colors, introducing some language, and he stayed with me. When I paused and did not label a color he briefly glanced in my direction; his way of requesting that I keep up the established routine.

I leaned over and placed my face on the far side of the translucent plastic and greeted him as a way to sample how captured he had become by the motion of the colored rings. As is often the case for children with autism, Peter was so focused on the visual movement that he was unable to extend his gaze or attention to include a person.

If I had been asked to draw a circle around Peter’s range of focus at that point, it would have included the toy but not the people in the room. This toy consistently provides a gauge of the child’s sensory engagement and simultaneous absence of social engagement.

Next: using the “Ball of Whacks” toy with a pre-adolescent child with suspected Asperger’s syndrome.

© 2010 Marilyn J. Monteiro, Ph.D. All rights reserved.

In this series of posts, I’ll be talking about some of the sensory toys I use in my autism team evaluations.

To start out with, though, I want to set the context by writing about the ‘why’ behind using sensory toys as a dynamic part of your autism evaluations.

Using sensory toys to start the evaluation conversation:

As you gain an understanding of the fundamental difference in the worldview of children on the autism spectrum, the use of sensory toys as a way to start a conversation with children becomes a natural choice.

Think about children you know who have autism spectrum disorders and answer this question: which of the 3 following areas represents the organizing principle for ASD children: language and communication, social relationships and emotional connections, or sensory use and interests?

Unlike neuro-typical children, ASD children organize their worldview around their sensory-seeking routines and their sensory sensitivities.

The use of sensory toys invites the child to relax as he or she uses the toys to create sensory-seeking routines. The child quickly associates you, the evaluator, with comfort instead of stress.

As you learn to use toys as the conversational bridge during your autism evaluations, you’ll find that the children relax, enjoy their time with you, and show you their capacity for communication and connection.

Next: how to use that water toy to get the conversation started

© 2010 Marilyn J. Monteiro, Ph.D. All rights reserved.