Foreword: There is such a group of children who cannot interact with others like ordinary children, cannot understand the words of others, do not know how to play with other children, play and interact together, will not use the correct and appropriate language to say their own ideas, whether happy or sad will not say, instead may be crying and tantrums. Addicted to certain toys for a long time, most children do not know how to play, explore, and do not share their feelings and interests for the toys that most children like. Some children also have problems with cognitive comprehension, which will affect children's language development and learning ability. So, how do we solve these problems in the face of children? Today, we invited He Jing and Wei Lili, two teachers from the Children's Encephalopathy Diagnosis and Rehabilitation Center of the First Affiliated Hospital of Henan University of Traditional Chinese Medicine, to talk about how to improve children's social communication skills and cognitive comprehension skills in family life.
Highlights of this issue:
Question 1: We just mentioned the symptoms of children with autism, so how do we find out that children have autism in the early stages? How do these children behave in the early stages? Teacher Wei
Wei Lili: When many parents come to the clinic, their expression is that the child does not speak, or will simply call his parents and feel that the child is backward in language. Many children have been evaluated systematically and found to be autistic. These children will have many abnormal manifestations in the early stages, such as eye avoidance. But the degree of avoidance varies from child to child, with some children acting as extremely avoidant, possibly having only one or two seconds of eye contact with others. And some children will look at each other for a relatively long time, and familiar people and strange people will not look at each other for a long time, and relatively familiar people will have a longer time than strangers. There are also children who do not react when they hear others call their names, or have fewer reactions, that is, poor call responses. At the same time, these children have finger pointing development disorders, ordinary children find their favorite items, they will use their fingers to point, and then they will look at adults with requirements or will share, and autistic children will find ways to take things when they want things, or just pull the adult's hand to reach for this item, then in this process, there is no eye contact with adults, they only pay attention to items. Many children can't follow the direction of other people's fingers to see things, and it is difficult to pay attention to an object with others. Most children have language delays, and after the age of 2, they will only be called "daddy, mom" or before, and after two years of age, they will not call. Children who cannot socialize with and play with their peers, or some children with mild diseases who have the motivation to interact but do not know how to initiate interactions with others. Some children behave as only repeating the words of others, which is what we call parrot learning tongue, for most children, like most of the toys we see every day, and some autistic children like a certain kind of toy, this toy can be played for a long time, turning a blind eye to other toys, no interest. Such a narrow interest will also limit the child's ability to explore the toy, affecting the child's development. Of course, there are also some 4-5-year-old autistic children in school, there are simple responses, but can not sit still, do not know how to follow the rules. Due to the problem of language expression and social communication ability, there is no way to integrate well into the same age children before coming to the hospital for treatment, they have no good friends, in the process of chatting with others, because they can't understand the meaning of the words, the understanding of the language stays in the literal meaning, and can not continue to talk with others on a topic, so they will also be rejected by other children, and can not be well integrated into the collective. If there are the above symptoms, parents should pay attention to it and seek medical treatment in time.
Question two: The reason why autistic children can't understand the meaning of words and can't play with toys has a lot to do with their weak comprehension ability, so what is comprehension ability? What are the characteristics of understanding in children with autism? Teacher He
He Jing: The so-called comprehension ability refers to the ability to understand any thing, which belongs to the development of abstract logical thinking in the advanced stage of human cognition. Understanding is like what we eat, it needs to be digested and absorbed to be converted into nutrition. Then comprehension is our brain's ability to digest and absorb for contact with a person, a thing, or a behavior. Then we generally divide the understanding into three levels of development, 1, the low level is to be able to identify and identify the object, and can name the object, know what it is, such as the child can identify what is an apple, what is an umbrella. This is a low-level level of cognitive ability. 2, the intermediate level is able to understand the concept, principle and law of the connotation, know how it is, such as the child knows what is the umbrella, and can well describe the appearance of the umbrella, under what circumstances to use the umbrella, what happened to the weather, this is the intermediate level of understanding. 3, the advanced level is based on the conceptual understanding, further to achieve systematization and concretization, re-establish or adjust the cognitive structure, to achieve the integration of knowledge, and to make knowledge widely transferred, knowing it is "why". This is the ability to recognize at an advanced level. It is also like learning numbers, at first you will just follow the numbers, can not understand the meaning of numbers and numbers, and slowly understand the numbers. Finally, the connection between numbers, quantities, and numbers is understood. From resolution to recognition to points. This is a process of understanding.
The importance of understanding, everyone should know, and deeply understand, in life, if it is not because of insufficient understanding, there will be no contradictions and misunderstandings, just like between colleagues, others say and do what you do not understand, do not understand the meaning, and quarrels and misunderstandings occur. The leader's instructions to your work, you do not understand, or misunderstood, bring trouble to the work, and be dissatisfied by the leader. Some things between friends have conflicts because they are not understood. The same child's lack of comprehension directly leads to a decline in the level of learning. Children in learning to master knowledge, first of all is important to understand the knowledge learned, then our human process of mastering knowledge must be carried out under the premise of understanding, and the ability to understand in childhood gradually developed and cultivated, in the education of children, constantly use children's understanding, judgment, reasoning ability, and abstract thinking consciousness gradually developed, is an important sign of the development of children's thinking to a high level, It is also the psychological condition and psychological quality that children can must have in various social activities after they become adults. Just like you read a good book, how can you use the good things in it to yourself, only learn to apply, then why many people read a lot of books but he can't use it, the focus is on the understanding, because there is no understanding, so he can't become his own thing, and then to do and innovate this content, therefore, comprehension is to help children better remember things just analyze the problem just to grow up, which is why we say that comprehension is one of the important basic qualities of young children. So what is the cognitive understanding of children with autism? Cognitive comprehension is an important foundation for the development of thinking and language, although the laws of cognitive and behavioral development in children with autism are basically the same as those of normal children. However, the rate of development is much more difficult than that of normal children, and there is a significant difference from children of the same age. For example: 1. Pay more attention to the details of things than the whole, such as allowing an autistic child to distinguish between "cat" and "dog", they may be able to determine the concept of "dog" by finding that the dog's nose is a shape, rather than catching clues by observing the overall situation like ordinary children. Therefore, autistic children often pay attention to only one detail when they recognize things, rather than the whole, which is also the main feature of autistic children's cognition. 02 Lack of cognitive connections, inability to summarize the law. Things in life are interconnected and have certain laws of development, and people's grasp of things is to find out their internal laws, conform to the laws and use them. Generally speaking, when children are about 2 years old, due to imperfect visual function, their sense of space and distance is also relatively poor, and they often wrestle, jump down from a high place or climb up despite danger. But after a once-in-a-fall, they usually reflect on their behavior, adjust their behavior, or avoid the place where they last caused him to wrestle. But children with autism often struggle to make connections with their perceptions of things. So sometimes we see that children with autism may have self-harm behavior because they can't express their needs in words, pay more attention to emotional expression, and can't associate pain with self-harm and self-harm. 03 Single way of understanding often refuses to change Autistic children in the cognitive process, the specificity of understanding things is very strong, often refuse to change. Some children are particularly attached to a certain kind of knowledge and things, but they are very reluctant to accept other knowledge and things, and some autistic children have weak ability to distinguish and screen things.
Question 3: In view of the problems of social interaction caused by the weak understanding ability of these children, how should we help children develop their social communication skills in daily life? Teacher Wei
Wei Lili: Through some of the previous symptoms, we probably understand the problem of social communication skills of children with autism, which is also their core symptom.
Children with autism have more content to cultivate social skills, and when cultivating social communication skills, they first need to get children's attention. Only when the child pays attention to you, the learning efficiency will be high. These children have eye avoidance, then you can choose what the child likes, as an entry point to attract the child, so that the child can see the eyes of adults, when the child and the parent have eye contact need to give things to the child to strengthen, and then slowly remove these auxiliary items. In life, you can interact with the way of games, such as playing with the child the game of the ball he likes, when playing very happy, the mother should set a pause, the child wants to continue to play the ball, will take the initiative to see the mother's eyes, in order to seek to continue to play, then we must continue to play to strengthen the child, in order to increase the child's behavior of looking at the mother's eyes. You can also intentionally let the child help the parents to work in life, such as throwing garbage, opening the door, helping the mother to take the cup, etc., in order to increase the child's ability to respond to people and the ability to listen to instructions. Slowly we can increase the distance and complexity of the instructions, and through this exercise, improve the child's ability to listen. If the child has needs, such as wanting toys, wanting to go out to play, wanting to go downstairs, then guide the child to use his fingers or use language to express the request. If the child is not able to complete it, then assistance can be given, that is, to help the child. If the child has language but cannot express, parents can use imitation to help the child express, such as wanting the mother to buy sugar to eat, let the child say "buy sugar" first, and then buy it for him. After that, when this situation is encountered, the child slowly learns to express his needs. When the child expresses it correctly, the parent must meet his requirements, then his future behavior of wanting to express these will increase, and he will take the initiative to express more and more, so in daily life, parents can use the situation in the environment, whether it is the child and the parent interacting in the game process, or going out to buy things, dressing, eating, going to the toilet and other natural situations, to guide the child to take the initiative to express. When a child has needs, his motivation to communicate is stronger, and we need to grasp these motivations and use them. Parents can also use "interruption" and "pause" in game interaction to provide children with more opportunities to express their willingness to continue playing, and also increase their children's opportunities to learn language. When many autistic children learn to express their needs and demands in words, their emotional problems will also be alleviated to a certain extent, and their parents' anxiety and parenting pressure will also be alleviated. As children's abilities improve and the accumulation of vocabulary increases, children slowly learn to make requests and answer questions. Children slowly learn to share interests, such as "Mom watch XX," learn to take turns waiting, cooperate with children, and understand the rules of the game. Parents can also learn to learn interpersonal communication and some things to deal with in various situations by reading picture books, telling stories, and making up stories for their children, so as to learn and apply them to life and improve their ability to get along with others in life.
Question 4: Understanding is so important, so teacher, how should we cultivate children's understanding in the family?
He Jing: As a sensory learner, children's comprehension can only use the method of image education, that is, to highlight the generalization of things with the help of object images. The limitation of children's thinking is that it is often easy to summarize from the superficial characteristics and individual aspects of things, and it is impossible to correctly and comprehensively understand the essence. A child's mastery of a word is not the same as mastering the concept that the word marks. So how to train, 01. Matching ability to distinguish between the same, different and similar items: The simplest training at the beginning is for children to first understand the concept of "same", can be paired and classified according to the same shape or color of objects, the pairing of two identical cards, the pairing of cards and physical objects, such as putting red balls with similar colors, red cars and red clothes together to make simple classification of different types of objects according to color. Or let the child distinguish between similar animals, fruits or daily necessities. After the ability is better, you can pair objects for the same purpose. For example, after we show our children shoes, we ask them to find socks in other objects and put them together. 02. The ability to understand the order of precedence. 1. Let the child place the blocks of different shapes in order. From big to small, from high to the bottom. From thick to thin. This is also after understanding the concept of size, height and thickness, and can be used to compare, which is also an improvement in understanding ability. A deeper understanding of the concept. 2. Listen to successive instructions in the specified order and make corresponding actions. a) Just like the action of washing hands (first turn on the faucet, then wash your hands, and finally close the water dragon head to wipe your hands) While the child is doing this thing, the parents should tell the child the process of the matter, so that the child's hearing, vision, and touch are involved. Because he understands the process and hears the language, then it is not just for the sake of washing hands. Instead, I have a better understanding of the order in which one thing is done, so that when I do something else, I can understand what the order is. When your child is familiar with the actual operation, then you can change to a card with a sequence. Have your child arrange the pictures in order a) indicate the "initial", "then" and "last" pictures; b) Use storytelling to encourage children to say the order of pictures. 03. The ability to distinguish, the things that are familiar to the child, parents deliberately say the wrong information, let the child think and distinguish between right and wrong, which is also a manifestation of the improvement of understanding ability. For example, when crossing the street, ask the child if he passes when the red light is on, wait when the green light is on, and let the child find the error and point it out. 04. Flexible switching of classification criteria. Let the child select and classify the appropriate object according to the prompts given, and be able to flexibly switch between classification criteria. For example, you can ask a child to sort a bunch of different objects by color or shape. Give instructions to put the "red" together, let the child classify according to the red, and then immediately change the rules, put the "triangles" together, and so on. Slowly let the child adapt to the way the rules are changed, the way the instructions are changed, and the child's flexibility and cognitive understanding of things as a whole are improved, so that they understand that an object belongs to more than one category, and the classification rules are variable.
The advice to parents is to practice the continuity of children's listening, issue more continuous instructions, and improve children's understanding. Tell the child more stories or things that happen around, and ask the child's key plot, improve the child's thinking ability and understanding, let the child feel things in life, you say he listens, he will soon forget, you say he goes to see, there will be a short memory, but if you let him operate, feel the process, then he can understand and understand, and remember forever.
Question five, scientific and reasonable methods can make our children's upbringing more effective with half the effort, so what do we need to pay attention to in the process of teaching children in daily life or in the process of parenting? Teacher Wei
Wei Lili: In fact, there are some children who have language but can't use it correctly, chattering and talking to themselves, but they can't correctly express their own requirements and ideas, and some can memorize hundreds of ancient poems but can't answer the daily simple "Have you eaten?" Such questions, not to mention the back-and-forth conversations in social interactions. There are also some children who have been following others to imitate, parrots learn tongues. This is because the child does not understand, or does not answer the question, in the form of imitation. Therefore, when teaching children to express, they must use it correctly in the situation and pay attention to the functionality of language.
In addition, we must also cultivate the child's ability to pay attention to the common, that is, what you see must also guide the child to follow and see, that is, the behavior of two people paying attention to the same object and event together. The attention performance of children with autism, they often can not follow the instructions to see, or even if they notice that the maintenance time is very short, their visual direction is rarely thrown to people, even if there is, it is mostly pulling, hugging and other actions instead of gaze and pointing behavior. These are a developmental defect in a child with autism. In life, you can point to many objects for children to see, guide children and you to be able to pay attention to an object together, slowly develop children can follow the parents' line of sight for transfer, and children's eyes can be transferred back and forth from the object to the human eye. This is a very important ability in social interaction. We can grasp various situations in life, such as the child wants the mother to blow bubbles, the mother blows a few times after a pause, waiting for the child to see the mother's eyes, if the child looks, the mother continues to blow, through such repetition, the child learns to use the eyes to express their needs, but also at the same time the child's eyes are transferred between objects and people.
There is also our concept of family members in the process of raising children to have consistency, sometimes parents and grandparents concept of inconsistency will cause the child's problem behavior to aggravate, often parents are more insistent on principles, the elderly are relatively pampered children, children may have improper behavior to express requirements, such as nodding, crying, if the child appears this behavior grandparents are immediately satisfied, then will strengthen the child's behavior, as long as the head crying can get what you want. We should teach children to use the right language to express and then give, and reduce the occurrence of bad behavior.
The child is diagnosed with autism, the parents are more anxious, but we parents still have to use a positive attitude to face the child, actively participate in the child's treatment, with our full and optimistic mood to affect the child, then our children will be better and better.
Guests in this issue:
He Jing
He is the chief rehabilitation therapist of the Children's Encephalopathy Diagnosis and Treatment Center of the First Affiliated Hospital of Henan University of Traditional Chinese Medicine, a member of the Integrated Traditional Chinese and Western Medicine Group of the Chinese Rehabilitation Medical Association, and a member of the "Children's Rehabilitation Cooperation and Development Alliance" of Henan Children's Hospital of Integrated Traditional Chinese and Western Medicine. Studied Montessori education at Qingdao Children's Hospital. Participated in the mental backwardness training course organized by the China Disabled Persons' Federation and obtained a certificate, and the national Montessori training course received a certificate. He is good at the treatment of children with intellectual retardation, autism, attention deficit and ADHD, especially for improving children's attention, observation and thinking skills.
Wei Lili
The first affiliated hospital of Henan University of Traditional Chinese Medicine, the first affiliated hospital of children's encephalopathy diagnosis and rehabilitation center in charge of rehabilitation therapist, Henan Rehabilitation Medicine Association of the first therapeutic group member, Henan Rehabilitation Medical Association Rehabilitation Psychology Branch branch of the special branch, the Chinese Medical Education Association of children's rehabilitation science committee members, once studied in Nanjing Brain Hospital children's mental health direction, engaged in child rehabilitation treatment for more than ten years, good at autism spectrum disorder, cerebral palsy, mental retardation, language development delay rehabilitation assessment and rehabilitation treatment, In particular, he has rich experience in the treatment of children and family rehabilitation of autism spectrum disorders, behavioral abnormalities, learning difficulties, language development disorders and other children.