These interventions are designed to parallel normal development and in doing so to overcome developmental lags. In other words, we introduce and guide procedures, which in normal infants occur spontaneously, so that the normal developmental progression might be restored.
Multiple orienting. This strategy is important for children who tend to "use up" a particular system. To "revitalize" the fatigued system and to bring the children into better contact with the therapist or parent, he or she constantly "changes his or her mind" in a way that requires the child to constantly refer to him or her to determine what must be done next. For example, a child who is starting to "drift" within a particular action system requiring going up stairs across a board, down stairs, etc. is abruptly—while in the middle of the board—told to jump off or to reverse direction, and so forth.
Restabilizing. When a child is drifting out of contact, restabilizing strategies may be helpful in bringing the child back from his or her self-preoccupation. To restabilize a child you need to repeatedly and unexpectedly pluck at the child's shirt from front to back and side to side in a way which throws the child slightly off balance. In the course of "righting" or "restabilizing" himself or herself, the child becomes more aware of his or her own body and is therefore better able to relate to you. Restabilizing often works best when the child is elevated by standing on a chair or bench that brings the child to your eye level. The plucking should never be so vigorous that the child falls—merely enough to momentarily and unexpectedly cause the child to adjust his or her balance.
Mutual face-touching. When a child repeatedly demonstrates eye aversion and poor awareness ofothers, the use ofmutual face-touching often proves helpful. Take both your child's hands in yours and begin, hand over hand, to have the child alternate between having one of his hands gently stroke your cheek and having you help him or her use the other hand to stroke his or her own cheek. This is done in a rhythmic fashion with you softly saying the child's name each time you help your child stroke his or her own cheek. Once this quiet, rhythmic alternation is established, you abruptly and unexpectedly break it by blowing on the child's hand. The dramatic contrast between a quiet and gentle rhythm and the abruptness of the blowing frequently induces a child to look intently at the adult—to determine what new strange event may be coming up next!
Restabilizing + mutual face-touching. When dealing with severe eye aversion, restabilizing followed quickly by mutual face-touching can be more effective in establishing meaningful eye contact than either strategy by itself.
Utilization. "Utilization" refers to a strategy—often introduced to help children emerge from tantrums—in which the teacher, therapist, or parent asks the child to repeat actions which were part of the child's tantrums. For example, if a child has been kicking and screaming, the teacher or therapist may tell the child to "kick" or to "scream" (but not at the same time). When the child responds to this request, a behavior which was initially an involuntary part of the tantrum becomes part of a system which is now linked to language. In other words the child becomes conscious of what he or she is doing. When that occurs, tantrums often disappear and the various actions are then performed more deliberately. Staff wishing to use utilization strategies must learn to distinguish between times it is appropriate to use it and when it is counterproductive.
Body schema. "Body schema" is a construct first introduced by Henry Head (1926), a neurologist, and later expanded by Paul Schilder (1951). It refers to the formation of a concept of the body that makes it possible to sit, stand, run, and jump, as well as to intend actions toward objects and people. While directly related to the body boundaries, the body schema extends beyond these boundaries, as when an amputee extends the notion of his body to include the prosthesis.
Zone of intention. The space within which a child on the autism spectrum can most effectively take in new information. Often this space is no more than 12 to 18 inches from the child's body. The task ofthe teacher or therapist is to be aware ofthe child's functioning zone of intention and to systematically expand it so that the child can take in information further away from the body.
Architecture. As used in the Miller Method®, the term "architecture" refers to the optimal relation between the child-object and person. A familiar example of poor architecture is when the teacher requires the child to put pegs in a pegboard but the teacher is standing while the child is seated and the pegboard is on the table. Improved architecture would be when the teacher is at eye level with the child, and the pegboard is between them at a height that allows the child to easily shift from peg board to teacher. Good architecture favors function;poor architecture impedes function.
Contagion. The tendency characteristic of poorly organized children to get "caught up" by the behavior of others. (In infant nurseries when one infant cries others also begin crying.) Deliberately established contagious situations are often used spherically (repetitively) to help establish systems.
Pacing. "Pacing" is a strategy that draws on the children's tendency toward contagion at early stages of development. Pacing is particularly important for children with system-forming disorders who have difficulty integrating or combining different components of a system. It consists of moving the child through the system quite rapidly so that the child has less opportunity to "lose" what he or she has just done. For example, when going up and down a slide placed at right angles to a set of steps, a child with system-forming disorder may well lose contact with where the steps are. Rapid pacing helps to correct this.
Narration. "Narration" is used in Miller Method® programs to help children connect what they hear with what they are doing. This is vital for developing receptive and expressive language as well as enhancing awareness of the self. The teacher or therapist "narrates" like a sports announcer what the child is doing while he or she is doing it. Vocal gesture is built into the narration in away which expresses the worker's delight with the child: "Andrew is riding his bike" (or climbing, jumping, etc.). Narration is far more important to the child than saying, "Good job!"
Spontaneous expansions. "Spontaneous expansions" refers to the ability of the child to deviate from the original or "prescribed" way of doing things: For example, the child going down the slide on his or her back or side, head first, feet first, etc. Spontaneous expansions are important precursors of executive function.
Executive function. "Executive function" refers to the child's ability to act intentionally in his or her surroundings. It includes planning, problem solving, and making choices as to which action-object systems the child wishes to activate or combine in new ways. Children capable of executive function have moved beyond the stage where they are "captured" by their action-object systems.
Important programs. Two important programs used in the Miller Method are the Sign and Spoken Language Program (SSLP) to develop functional communication and the Symbol Accentuation (SA) Reading Program to develop both sight and phonetically based reading and writing. Both programs draw heavily on system concepts.
Note: Those seeking a more comprehensive discussion of cognitive-developmental systems theory—and the various programs generated by the theory—will find it in our previous book, From Ritual to Repertoire (Miller and Eller-Miller 1989).
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Autism is a developmental disorder that manifests itself in early childhood and affects the functioning of the brain, primarily in the areas of social interaction and communication. Children with autism look like other children but do not play or behave like other children. They must struggle daily to cope and connect with the world around them.