With contributions from: Anne Faraher, Kathy Alvear, Linda Wright, Jen Wills, Terri Kim, Francisco Chavez, and Mariko Okano
Street safety is a common concern amongst parents of children with autism. Often we find our clients may be unaware of the dangers associated with crossing the street, and measures must be taken to increase this awareness and ensure safe pedestrian behavior. This topic has been discussed multiple times within an email group of Lovaas Institute consultants. The following are some of the ideas contributed.
I have a 6-year old client with whom we are addressing these concerns. So far we have been teaching him to walk with an adult and are teaching him the rules to cross the street (making sure to include the rule, "Ask a grown-up"). Even though we do not expect him to cross the street independently, we're hoping to teach some awareness. Below are the two programs we are currently using.
Step One: Sequencing
SD: "Show me how to cross the street" and presents phrase cards.
R: Child puts phrase cards in correct order
SD2: "Tell me how to cross the street"
R2: Child reads the cards.
2. Hold hands
3. Look both ways
4. Ask a grown-up if it is OK to cross.
Step Two: Mock Street (practiced in the backyard)
SD: "Let's cross the street."
R: Child takes instructor's hand and says, "Hold my hand."
Step Three: In Vivo
See step two, but conducted at a real (quiet) intersection.
SD: Instructor says, "Walk with me."
R: Child walks next to instructor for target distance.
1. You can take pictures of people in dangerous situations and then in an alternative, safe situation (e.g., someone standing in the middle of the street, and then the same person standing at the curb). Teach the student to sort the pictures or identify the 'Safe Way' versus the 'Unsafe Way.'
2. You can then teach questions targeting "why" such behaviors are unsafe and what to do instead (use visual cue of the 'Safe Way' as a prompt). You can target situations that are of particular difficulty to this student as well as others.
3. After the basics are acquired, you can test the student's comprehension of these rules by teaching him to respond to the questions when in the natural situation (e.g., When approaching the street ask, "Should you run in the street?" The student should respond, "No." Then ask, "Why not?").
4. Generalize the skill by setting up situations where others are behaving in an unsafe way. Teach the student to identify the incorrect behavior in others and to then identify a safer, alternative behavior.
You could try video modeling. I would make a videotape from the child's point of view. That is, stand at an intersection, and point the camera to the left, and then to the right, and then place a blank sheet of paper in front of the lens for a few seconds. Repeat for several minutes. You should have a videotape of instances when it's safe to cross (no cars in sight or they're really far away), and not safe to cross (cars are coming).
I would watch the tape with the child, and teach him to identify when it's safe to cross vs. unsafe. (You may need to tape a series of safe, and a series of unsafe circumstances to show him the difference, then teach discrimination between the two).
For generalization, you could have him stand on one side of the room, and cross to the other side only if he watches a "safe" segment on tape. For generalization to the real world, you could start by having him stand with an instructor on the street where the modeling tape was made, look to the left, then right, and tell you if it's safe or not to cross.
You may need to make several tapes before he generalizes this skill.
You could create a video using siblings, cousins, or friends. You can tailor the video to situations that your client is familiar with and even record the segments on the actual streets on which he will be walking.
One method I have used before employed a token system. Prior to taking the child on the streets, we contracted for a reinforcer, reviewed what behaviors earned tokens, and which ones lost tokens. We then asked the child to walk from where we were to where the reinforcer would be obtained (e.g., ice cream shop). We always had him begin in a location that would require him to cross a few streets in order to get to the destination. We didn't review the tokens earned until we reached the location to make sure he was attending the whole time and not just responding to our verbal reinforcer or reminders. This really helped the child be aware of what he needed to do because his reinforcer was contingent on appropriate and safe behavior on the walk to the location where the reinforcer was to be obtained. Depending on your client's skill level, this may or may not work.
You could teach this using a sequencing exercise, presenting three scenarios: (1) look both ways, no cars coming, cross street, person safe on other side, (2) look both ways, car coming, wait, then cross, safe on other side, (3) forget to look, get hit by a car. For pictures you could photograph the back of someone completing the first steps and use a magazine picture of someone hurt/bleeding. You could use the pictures in various ways: choose what "you should do" or what "you shouldn't do."
I have had success practicing identification of moving vs. stopped/parked cars using toys and figurines. You can teach the child to identify parked and moving toy cars that you are manipulating. The child can either say or gesture when it's safe to cross the street (or manipulate his figurine). Once my client demonstrated acquisition with this format, we were able to generalize (with teaching) to a real life situation on an actual street.
I have worked with some children who are very cued into adults' emotions. For these kids, I've capitalized upon this and asked the instructors/parents to exaggerate cautious/fearful body language when a car is approaching. We also made a point of abruptly jumping back onto the curb (we would initially hold the child's hand), or a make a quick run to the other side of the street if we were already in the middle of the street. This is actually how my own children learned street safety (my daughter is 3 and can independently exercise street crossing rules, but of course we continue to supervise her), and that's how I got the idea. I know it wouldn't work for all kids, but it might help for some.
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The names of all children in this newsletter have been changed in respect for family confidentiality.
During teaching, have a toy guitar, piano or drum nearby. When the child responds correctly, pull out the instrument and sing a line from one of their favorite songs. After another correct response, sing the next line. You can do this after each correct response or more randomly to build anticipation! Sing the rest of the song at the end of teaching!
Hold a tissue and pretend you are going to sneeze, then blow the tissue towards the child! Or pretend that you're going to sneeze while the child is sitting across from you in a chair, then "sneeze" the child back in his chair or spin the child around while holding hands!
Place a piece of a favorite snack at the far end of the table, then pretend like you're going to get it first (e.g., "It's mine, I'm gonna get it!!" while hitting your hands on the table toward the snack). Let the child get it first!
That's My Chair!
When the child comes over to sit down for teaching, say, "Hey, that's my chair!" Then quickly switch spots with them. Then change your mind, "No wait, I want to sit there instead!" Then quickly switch spots again! Keep doing this a few more times to get the child giggling!
Use your finger to "write" a letter on the child's back, and have the child guess what letter it is. Each time the child responds correctly during teaching, write a new letter until you have spelled a fun word!