Engaging Autism (A Merloyd Lawrence Book) Paperback – February 10, 2009

The first time I ever read one of Greenspan's books (Building Healthy Minds) was actually before the birth of our first child. I was on a mission at the time to digest as much on child development as I could, because I wanted to be more then just a mom who didn't repeat what she'd seen growing up. I wanted to try and put the best of me I could into it. At the time, I didn't specifically anticipate ever being the parent of a child with ASD. I knew our son could have some learning challenges when we adopted him because of his prenatal history, though things looked more developmentally normal for the first 8-9 months of his life with the exception of some tactile defensiveness, and then things started to go off track. By about 13 months, we were on a train that felt totally out of control and it felt like we started collecting diagnoses like they were beads on a charm bracelet, and I now own several of Greenspan's books, including this one. I will eventually get around to reviewing all of them, but it can be emotional for me to write these as I remember the past, so I may trickle them out in time.So our son was given the ASD diagnosis in 2014 when he was 2.5 years old. DIR is not our only therapeutic approach with him, because in our state, ABA is the only one of the therapies that is covered that addresses the symptoms of Autism, and ASD is not his only diagnosis. For our son, I think both approaches have their value and their uses. So, my first piece of advice is about something you may have already encountered: many times parents of children on the spectrum will tell you what worked for their child and say this is for sure going to work for your kiddo. You know, I'm not trying to do that. I think DIR is a good approach, and it may certainly help your child, but I think therapeutic approaches are best tailored to each individual child because the circumstances can vary so much, and this is an area where knowing your child is important in directing your approach if possible. But you may need to experiment with some things to figure out how each approach affects them. And sometimes, knowing your own personality and how you feel comfortable interacting can also be a necessary component in deciding approaches as well.DIR is different from many forms of ABA in that you follow the child's interests and use those to “enter into their world.” Once they are interacting with you doing whatever it is they are doing, even if it's a behavior you ultimately want them to not be doing, like turning the light switch on and off repetitively, you can start building engagement, joint attention, and communication skills and work towards modifying what they are doing into something more functional. One of the reasons I like DIR so much is that I feel like it does a great job of recognizing an important rule of social reciprocity. Greenspan himself points out in this book that when you go to a party and meet new people, you often try to engage them in conversation about their interests, et cetera first and I agree with him. I feel like sometimes ABA is a bit more authoritarian in that it is very focused on teaching the child the current model for socially accepted responses without helping them to first feel the joy of socially connecting with others. And with some things, for my son, unless he feels that joy, it doesn't matter what kind of reward, reinforcer, or treat you offer him. He's not going to cooperate with you. Period.Unlike some of the other therapeutic approaches, DIR allows for the use of other methods concurrently without insisting on exclusive devotion to this. DIR can be very time consuming, and it can require a great deal of creativity and trouble shooting. But if you have a child on the spectrum, especially if they have significant challenges, anything effective is going to require extensive time supports. I think this book does do a great job of explaining things, but I also like the book “Floortime Strategies” by Davis/Isaacson/Harwell because it's a bit more concise and can serve as a great reminder/refresher. Also, even though Dr. Greenspan himself is deceased, there still is a website in his name being maintained that has teaching resources for the Floortime approach.The one thing I would mention about this is that the authors state that challenging behaviors will lesson over time as they become drawn into the shared world. I would say that if a child's behaviors are sensory based, that may not be the case. For our son, one of the reasons he bangs his heads onto things is that he has sensory imbalances involving his vestibular senses. And, because his deep pressure nerves are less responsive, he doesn't feel the damage he does when he bangs his head hard, so it's not self limiting that way, and it can be scary when he tries to do it with a lot of force. He had a dental procedure a few months ago that threw some of his sensory stuff out of whack, and the head banging which we had pretty much fully extinguished came roaring back with a vengeance. Like, 2-5 hours a day for the first few weeks post procedure kind of vengeance. Because the problem started sensory, being in a shared and engaged place isn't going to completely get us back to where we were, so we've been using an approach that uses some DIR, some sensory integration, and some ABA and we're down to 5-15 minutes most days, but we're still not back off that hill yet. And this is one where I'm going to agree with some other authors who are behavioral specialists that you may need to hold your child in a basket hold for a time to keep them safe before you can get them to calm down enough to engage in other forms of communication or behavioral substitution with this. Otherwise, I do agree with the strategies given for challenging behaviors in this book, just be prepared it could be a marathon and not a sprint depending on what is going on with your child.My son recently turned 5, and sometimes people look at him and his list of diagnoses (they total 5 currently and include other developmental disorders) and that is how they choose to define him. They see that his overall level of functioning is much lower then that of a typical child his age, especially since he's non-verbal. But you know what? He uses the potty. He self dresses. And he communicates with us for a number of things on his speech device, and those are big accomplishments to have. If there is one gift I could give people, it would be to see what things were like 4 years ago, because comparatively speaking, I think he's doing very well. And there's never been any doubt that he loves me and feels that bond, because I've taken time to be in his world with him and I know what love looks like to him. And, regardless of how low functioning people tell you your child is, pay attention to everything they do. Two years ago, when my kiddo still couldn't imitate most anything, my friend L came over for lunch. He wanted her phone, but she wouldn't give it to him. So, he grabbed her by the hand, led her over to his toy bus. At this point, I've seen a few of his schemes, so I'm watching suspiciously because I know. My son does not like to roll a bus back and forth, but he's already experienced her trying to get him to do that, so he knows that's what she wants to do. So she sits down and once she's got her hands on the bus and in a difficult position for chasing him down, he gets up and runs quick as he can towards her phone. Which I beat him to, because at this point, I'd already been caught off guard by some of his schemes and I had come to be on the look out for them.I would say, if you see those types of moments, while believe me this type of ability to plan can be really scary in a child without risk assessment abilities, this is still what hope can look like. Every time my son problem solves to get out of something (like trying to throw away his crayons so I won't continue practicing scribbling with him as part of an ABA target) or to try and get something he wants, I rejoice. Because if he can problem solve that way, I feel like that list may not define him long term to the degree some people might expect it to. And other then saying I have experienced how effective DIR can be in engaging my son, that is the one thing I would really want to encourage. We needed to know his diagnoses to know the best way to take care of him and to get him the services he needs, just as you needed to know that for your child, but they are not ultimately who he is. And that is something I love about DIR. It can help your child feel comfortable enough to reveal to you who they really are underneath the behaviors that come with the labels.

I have a high functioning son on the spectrum. He is currently in speech therapy with another kiddo on the spectrum working on conversational speech and higher level thinking. He didn't understand cause an effect very well...difficulty with why and how. I used the strategies in this book and questioned everything he did in a playful way. After 2 weeks he was able to answer why questions 90% of the time and the rest of the time he would answer like any typical kiddo with an answer that didn't quite make sense ;) One week later he was giving me multiple answers for the why questions (2-3) spontaneously without me even prompting additional answers.I have seen my kid expand his vocabulary and communication with me, his peers and others over the last 6 months with once weekly speech therapy. But as soon as I implemented these techniques in our everyday life his progress grew significantly.I like that this book has techniques for different levels on the spectrum. A very good read and well worth the money! I haven't read alot of books yet as my kid has been recently diagnosed but this is one that I would recommend highly.

I highly recommend this book for anyone searching for information on how to communicate with a child with ASD. After recently learning that my 4 year old grandson is autistic, I wanted to learn as much as I could about how we can help him. This book gives detailed information about the various degrees of autism and how families can work (engage) with an autistic child, as well as how to find the professional help needed. Because it is written by two doctors, some of the medical terminology was difficult to understand, so I took the time to research meanings because it is extremely informative. I have highlighted sections that are more significant to my grandson so that I can share this book with the rest of the family. It clearly gives us a better understanding of what this child is going through and how very important it is to engage with him on his level.

Floortime allows the clinician to have other perspective about Autism and other developmental disorders. The book is easy to read and understand for parents and professionals. It explains many playful forms to get engaged with your kid and gives many examples of the problems as a parent we can have trying to follow her lead. It is very insightful and a different point of view of how to approach discapacities.

This book was given to me after my daughter was diagnosed with autism (among other things) and I was told that there was no hope for progression. The first thing that I discovered in reading the book is that my daughter does NOT have autism. How autism should be diagnosed and the mistakes that are often made in diagnosing were enlighting and I only wish I had read the book before I paid lots of money for a wrong diagnosis. The second thing that I learned is that there is ALWAYS hope regardless of the diagnosis. As far as the DIR/Floortime approach, I think that it would help any child (developmental problems or not) become happy and emotionally stable and reach his/her full potential. I implemented just a few of the principles as I was reading and saw immediate results. I plan to implement much more. The book is great - not only does it give you a plan, but it offers real hope.