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What do Neurodiversity Affirming Goals look like for Autistic children?

Exploring Neurodiversity Podcast – Episode 4

by Adina Levy

Play. Learn. Chat - Exploring Neurodiversity Podcast Logo

Show Notes:

In this episode we discuss a range of key considerations to ensure that goals for autistic children’s support are Neurodiversity Affirming, useful and relevant to each child.
We’ll discuss the need for goals that support an autistic child’s regulation, connection, and overall well-being. Goals should not only seek to change the skills of a child, but we should instead have goals that aim to change the world around the child. This includes supporting other people’s knowledge, perspectives, and skills in supporting and accepting each child, as well as their physical environment.

We talk about the importance of meeting an autistic child’s sensory and emotional regulation needs before asking for any other goals to be met. Communication goals should not just focus on speech or mouth words, but rather include all forms of communication, whatever is preferred by the child in each moment. Social interaction goals should not be based on changing an autistic child to appear more neurotypical or forcing eye contact. Affirming social goals can exist, if they are aligned with what a child wants.

I also share a paragraph that I add to the start of goal summaries or plans, which is an example of how you can introduce Neurodiversity Affirming goals. You’re welcome to use and edit it to use for your clients or child:

These goals are to be supported when Amelia’s sensory and emotional support needs are being met and she is well-regulated. Learning and development will happen better when she is regulated.
Amelia’s interests and personal preferences are important. We will support her to explore these more in and out of therapy sessions. Interests and fun will be incorporated at all stages of working on the below goals. Amelia’s interests will not be used as rewards for doing other, less-interesting things.
All communication methods are OK and valid: The goals are to be supported honouring Amelia’s preferred communication method/s in any moment. For Amelia this generally includes a mix of using body movements, sounds, some mouthwords, and she is beginning to use her Augmentative and Alternative Communication (AAC) Speech Generating Device. Our priority is connection. We do not push or pressure Amelia to communicate using only speech, if that is not within her abilities.

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     Links

    📝 Free download for parents – Goal Setting Guide & Workbook: https://playlearnchat.ck.page/c73185e86e

     

    👩‍💻 Webinar for parents – Affirming Goal-Setting for Neurodivergent Children: https://courses.playlearnchat.com/offers/2E3y5pDR/checkout

     

    👩‍💻 Webinar for Allied Health Professionals ‘Affirming Approach to Goal-Setting and Reports’: https://courses.playlearnchat.com/offers/FfxMa9ea/checkout

     

     

    Podcast Link: https://pod.link/1625478932

    Website: www.playlearnchat.com

    Instagram: https://www.instagram.com/play.learn.chat

    Facebook: https://www.facebook.com/play.learn.chat

     

     Transcript:

    Welcome to the Exploring Neurodiversity Podcast. I’m Adina Levy from Play Learn Chat. I’m a neurodivergent speech therapist. And I’m obsessed with creating a world where neurodiversity is understood, embraced, supported, and celebrated. Join me as we have conversations about autistic, ADHD, neurodivergent experiences, and I share how you can support neurodivergent children in your world.

    Let’s all work together to make change where change is needed so that the world can be a more friendly place for neurodivergent people and for everyone.

    What do neurodiversity affirming goals look like for autistic children? This is a huge question that comes up time and time again in my work with therapists. And also for parents who are wondering. What are good goals for us to have? Now, there is a whole other conversation about whether it is appropriate to set firm goals for humans at all.

    That is a conversation I’ll leave for another day. I think it’s a really interesting one. And I think we need to individualise the question of whether a person should have goals written about them or generated for them in the first place.

    If you’re listening to this as a therapist, I hope that you’ll take some notes and create some ideas about how you can change your goal setting practice, or the focus of the goals that you do set for your students or your clients.

    If you’re listening to this as a parent of an autistic child. I hope that you will also be, take some notes. And check in with the goals that you currently have set for your child, check in with your therapy team and perhaps make some changes together about your child’s goals going forward, to shift them into a more Neurodiversity Affirming approach.

    So for starters, we need to look at what is the purpose of a goal. If a goal has the purpose to make a child’s life better, to support them to feel more regulated. To support them to feel better connected to increase their wellbeing. That’s probably a wonderful goal. We need to ask ourselves, does it help the child meet their needs, and wants. We have to take into account that neurodivergent children, just like every other child have wants and preferences. So it’s not just about meeting their basic needs, but also supporting them to have a rich and connected life full of their interests and their passions.

    Of course, we need to be supporting parents to support children and a goal that helps parents have a easier time of life, can be a valid goal, but not if it’s at the expense of the actual child’s needs, their true deep needs.

    It’s very valid for parents to need support, to be the best parent that they can be for their child. And parents, you might need your own support network, perhaps friends, family members, therapists, for yourself to support you, to understand, accept and guide your child in a way that is most supportive for your child.

    We have to understand the whole family unit and especially when kids are younger or have greater support needs from their parents. Parents need to have a lot of capacity to be able to deal with the challenges that come with having an autistic child, a child who’s living in a world that is quite challenging on a sensory level, on a communication level, on a social level for them.

    So parents, we love you. We support you. But let’s keep reminding ourselves, what are we doing for the children as well? So if you have a goal that is about making a parent’s life easier, let’s also check in, does it actually truly support the child? If not, how can you find a goal that helps both child and parent.

    Who does the goal benefit, and at the end of the day, let’s hope that it is for the benefit of the child.

    If a child can’t tell you what they want and what they need. We need to get our interpreting hats on.

    You can use their behaviour, their actions, what they say and read between the lines of what they don’t say sometimes.

    What does their body language tell you about what their goals are and what they might want for themselves, if they could communicate that to you?

    Another key aspect that we need to keep in mind when setting goals. Is co-design goals. This is a huge, important factor.

    As therapists, many of us say that we do child centered therapy or family centered therapy. And many of us do. And some of us do not. So I want you to think about your whole goal setting process, your assessment process, even, but especially how do you go about determining what is going to be the focus for that child’s next steps. How do you review that with the child, with the family? How do you get the child’s input?

    How do you learn about what the child genuinely wants and needs?

    It’s not just me that says that this is a good idea. We have our brand new National Guidelines for Supporting the Learning Participation and Wellbeing of Autistic Children and their Families, which has recently been released in Australia. And this has a huge emphasis on family centered and child centered support. So goals and support need to be designed, not by the therapist or by the team around the child, but together with the child, together with the family.

    So let’s get into some types of goals that you might want to have in a goal plan for an autistic child.

    We need to start by thinking about the goals around a child. What do I mean? I love talking about changing the world around kids. We don’t just want to be asking kids to do all the learning, and the changing. We want to support people around the child and the world, the physical world, and the structural, time world around the child to change.

    I know that for a lot of therapists, we have ideas around this. We might have ideas about doing parent coaching. But they become hidden often and we don’t actually write them down as goals. We don’t make them concrete.

    So for instance, we might have a goal for a child to say, we’re going to support Johnny to increase his communication at home and at childcare. And that’s the goal written down, but all that says is we want Johnny to change. What we haven’t written in that goal is about who else needs to change and learn and do something different or get some new information.

    So instead a goal could look something like. " Johnny’s parents will attend a webinar and learn information about how to support Johnny’s communication skills". It could even include a goal about childcare educators. " Childcare educators will work with the therapist, with monthly sessions over the next six months to support their capacity to help Johnny with his communication skills at childcare".

    So let’s make sure that if we do have goals around the child, we are making it explicit, discuss it, make it clear, write it down, have that in your goal plan.

    What are the changes needed to other people’s knowledge perspectives and skills to support and accept the child better. What are the changes that are needed to the physical environment or to the structure of the child’s life? I talked about the time structure. So I’m thinking about the schedules or the expectations that the child is expected to meet.

    So rather than have these goals secretly hidden in invisible ink. Make sure that we’re writing them down, making them clear, obviously discussing with the child and family.

    Another type of goal that needs to appear in a child support plan can be around sensory and emotional regulation. If you are a therapist, it depends on your profession. What that will look like. Often, we might assume that sensory regulation falls under the banner of occupational therapists only. And I would argue that anyone supporting autistic children needs to be aware of sensory regulation needs, preferences, challenges, and include some form of sensory support for kids.

    This can include supporting their awareness and advocacy about their own sensory needs. So, for example, a speech therapist it’s super appropriate to understand a child’s sensory needs and preferences so that you can use them within your sessions with the child. But also support them to communicate about their needs in a way that is appropriate for their level and their skills.

    Importantly, we need to ensure that we are expecting that sensory and emotional regulation needs are being met before any other learning goals. This comes back to the very old and still really solid Maslow’s hierarchy of needs.

    Essentially, we need to ensure that a person’s basic needs are met, before we can expect that their higher level capacity is there. So we need to ensure that somebody is feeling safe and secure and physically okay. And warm and fed. And that includes feeling safe and regulated on a sensory level, feeling connected and supported on an emotional level. And only then after all that’s in place. Then we can have learning and development of skills.

    At the end of this podcast, I’m going to share a script for one example of some text you could use. If you’re a therapist or as a parent, you could ask your therapist to use something like this, at the start of any goal summary or goal plan, which will contextualise the goals. We’re going to be including the idea of sensory and emotional regulation being a bit of a baseline before any other goals are worked on. So stay tuned for that.

    It’s really important that we’re focusing on interest based and child centered topics activities.,

    It is not okay to be with holding a child’s preferred topic of interest or activity of interest to the end as a reward. That is not the best way of doing connection, doing learning, doing support. It’s an old fashioned way. It’s the way probably many of us were taught by our clinical educators or our bosses.

    If you’re in the habit of using reward chats in your therapy sessions, for example, you know, I do five boring things, and then you get the fun thing. Stop, re-examine the way that you’re connecting with kids and supporting them. And do a big flip. So what I’m asking for here. Is that we are looking at supporting kids to learn through using their interests, through discussing their interests, exploring them through playing the fun games and embedding learning goals and anything else within the context of fun, interesting, motivating activities.

    I’ll have a lot more about this topic in a future podcast episode as well.

    Another type of goal that is very close to my heart as a speech therapist, but again, I think applies to any therapist supporting autistic children. We’re talking about communication goals. Let’s start from the premise that all communication is. Okay. That means all communication methods are valid. And we need to be supporting children to communicate in whatever way is best for them in that moment.

    It also means that we’re stepping back from the abelist assumption that speech or mouth words are superior to any other way of communicating. That idea is not acceptable.

    And it only leads to massive frustration for children or people who are not able to, or not reliably able to use speech to communicate.

    Communication is all about connection. Our goal for kids in our communication goals for kids need to be primarily about supporting them to reduce frustration and increased connection. Rather than just being about training them to communicate in ways that seem most easy for us to interpret.

    It is okay to have parallel goals that support a child to increase their ability to communicate in any way using any communication method that is best for them in that moment. And at the same time, be supporting them to increase their ability to use speech or mouth words. That’s okay, but let’s remember, you don’t actually have to have a speech goal or a mouth words goal.

    Oral communication or using mouth words is very difficult for some people. It is impossible for some people, it is variable for some people. There are so many reasons why it might be hard for a child to use mouth words. And again, that’s something I’ll talk about in more detail in a future episode.

    Just some of these reasons include: difficulty with motor planning. So this can show up in childhood apraxia of speech.

    It can be feeling emotionally overwhelmed and mouth words just suddenly become unavailable. Even if they sometimes can speak.

    It can be hard to use mouth words if they’re feeling tired, dysregulated, there are so many reasons why mouth words may not be the best or most appropriate way for a child to communicate in any one moment. So we’ll step back and remember the phrase. All communication is okay.

    In many cases. For therapists, it may be about supporting parents to understand this concept. I’m here for that journey. Please send them to my podcast. And if you’re a parent, and this is something I talk about in great depth in my, in my parent course, Connect & Grow. That’s something I’ll pop the links to in the show notes.

    So while there’s always a lot more, I could share about communication goals. I’m going to leave you with that idea. Am I going to move on to one more really important aspect of goals which is often in autistic children’s goal plans. Social interaction goals.

    Now. I’ve been talking about this a lot in the past few episodes. So go back and listen to episodes two and three. If you haven’t already for more background. Around on what I think Neurodiversity Affirming social support looks like.

    Social interaction goals for autistic kids can not be based on changing a child to appear more neurotypical. We should not have eye contact goals. Having a goal about supporting a child to make a better eye contact is bad. There’s no other way to do it. I can’t sugarcoat it. We do not need eye contact to have good communication. For some autistic children, eye contact can be distracting, painful, confusing.

    All other kinds of things. If you are praising a child for giving good eye contact, you might also be supporting them to focus deeply on staring into your eyes, while they’re actually truly missing your message. They may be so focused on looking at your eyes or figuring out which eye to look at, or perhaps noticing a stray eyebrow hair, that they aren’t actually able to process what you’re saying to them.

    It’s not the right approach and it’s not the most important part of interacting with another person. So we need to leave eye-contact goals in the past.

    Little side note here is that it is appropriate to remind kids that we can sometimes get information from other people’s faces. So it is okay to glance at other people’s faces now, and then to get a bit of information. But even then we don’t get the whole story. We can’t actually know exactly how someone’s feeling by looking at their face.

    We can get a clue. We can have a guess, but we don’t know their internal experience. We can get more information now when we ask them: " Are you feeling confused?" "Did I just bore you?" " or " Do you want to change topics?".

    Another key concept when we’re talking about social interaction goals is the idea that I love talking about is all play is okay. And that extends to all socialisation is okay. That means all social preferences are okay. We need to honor a child’s preferences for how they interact with other people. In what kinds of ways in big groups, in small groups, how often, how much of their time they want to spend socialising.

    It is okay to have social interaction goals when they are based on a child’s preferences for increased social connection. That’s fine. That’s great. But we’re coming back to the idea of what does the child want.

    Broadly. We want to support children to increase their self-awareness of their own preferences, their needs, their interests. We want to support them to self-advocate more and also support them to be surrounded by people where they mutually like each other. To find people who accept them.

    It’s okay to have goals around supporting the child to co-design scripts with you. If that’s helpful for them, you know, things that they can say in certain situations. But it can’t be prescriptive. We’re not telling your child, you have to do this. Co-design is the important word here. So if that’s a helpful strategy for your child, and certainly for me as an autistic human, I find it very helpful to rehearse my own scripts out of a situation that I can use when I’m in a tricky situation.

    If we’re doing that approach, we need to ensure that the way we’re doing it is supportive for the child. That the goal itself is something that the child wants help with.

    So keep coming back to that question. Does it help the child meet their needs and wants.

    So I said earlier on that I was going to share a bit of a script for you. This is some text that you could use at the top of a goal summary or a plan, to give some context to the goals and the ideas behind them and how they’re going to be worked on and the assumed baseline. And what we assume is already in place before learning goals can be worked on. Now I’ll pop this text in the show notes and you are very welcome to copy it, change it, amend it, make it your own and use it for your own practice. If you’re a therapist, you’re welcome to do that.

    If you’re a parent, you might want to do this write for your child and share it with a therapist as your philosophy around goals.

    These goals to be supported when Amelia’s sensory and emotional support needs are being met. And she is well-regulated. Learning and development will happen better when she’s feeling regulated. Amelia’s interests and personal preferences are important. We will support her to explore these more in and out of therapy sessions. Interests and fun will be incorporated at all stages of working on the below goals. Amelia’s interests will not be used as rewards for doing other, less interesting things.

    All communication methods are okay and valid. The goals are to be supported, honoring Amelia’s preferred communication methods in any moment. For Amelia, this generally includes a mix of using body movements, sounds, some mouth words and she’s beginning to use her augmentative and alternative communication in brackets, AAC, speech generating device.

    Our priority is connection, and we do not push or pressure Amelia to communicate using only speech. If that is not within her abilities.

    So I hope that that’s helpful. As I said, you’re welcome to take this text, use it however you wish, change it and make it your own.

    I’m going to just share three quick ideas where you can get further support for all of the above. So for parents, I have a free download, which is a goal-setting guide and workbook. It’s 12 pages of information, exercises, examples, all kinds of things for supporting you to develop holistic, neurodiversity affirming goals for your child.

    Also for parents, I’ve got an upcoming live webinar and the recording will continue to be available. That’s the Affirming Goal Setting for Neurodivergent Children Webinar. We’re running live on the 24th of April. And if you can’t make it live, no worries. If you’re listening after the date though. Worries.

    It’s lovely to come live, but it’s also totally fine to get access to the recording. I’ll pop the link in the show notes.

    And if you’re an allied health professional, a therapist or a therapy assistant, I have a recorded webinar Affirming Approach to Goal Setting and Reports, which I ran just yesterday and it’s awesome. It’s huge. There’s so much in there we go a lot deeper into all of these topics. And of course, talk about affirming report writing as well. That recording is available, anytime again, you get 12 months access. So check out the link in show notes. If you’d like to watch that webinar.

    Thank you so much for sharing this audio space and time with me, and thank you for being open to learning and unlearning and truly listening to the neurodivergent experience and perspective. If you found this episode helpful, please share it with a friend and join me on Instagram and Facebook. I’m @play.learn.chat that’s Play.Learn.Chat, you’ll find all the links that we discussed in the show notes.

     

    Have a spectacular day.

     

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