While I would not consider myself to be an expert, or even the ideal candidate to write this post, I may know more than the average person due to my work experiences and so I figure I will give it a go since I have seen people requesting suggestions on how to work with children with autism or ADHD.

Before I began teaching Suzuki piano, I worked in the mental health field for 5 years. At my first job, I worked as a therapeutic day treatment clinician in public schools, mostly elementary, but I also did a year stint at the local high school. After doing 3 ½ years of day treatment, I went to work for a private day school for children with autism. My job duties as a day treatment clinician were to provide in-school support for children with various mental health diagnoses including ADHD, severe anxiety/depression, oppositional defiant disorder and PTSD.

My responsibilities at the private day school were more intense, as these children had been sent to this school because they could not function in a public school classroom; not even in the classrooms specifically designated for children with autism. Daily, I saw much more aggressive behaviors at the private day school than I had in the public schools, including biting, hitting, kicking, pinching, throwing objects, and destroying the entire classroom. Oh, and let’s not forget spitting. One thing that was made clear to me is that children will do just about anything to try to communicate their needs or desires. Across the board, it seemed that the less verbal a child was, the more aggressive he was. To me, it made sense. How would I like to be a prisoner trapped in my own body without means to communicate effectively?

In our training, we were taught about the four functions of behavior:

• Access
• Attention
• Escape
• Automatic

Part of our job was to track various behaviors to determine what the function of the behavior was. Why do these children do what they do?

In summary:

• Access behaviors
  • Goal – To acquire something
  • Example – Billy wants to use the computer. All of the computers are taken, so he pushes one of his classmates out of the way in order to gain access to the computer.
• Attention behaviors
  • Goal – to get others’ concentration on them
  • Example – one of our students was notorious for spitting at others to get attention. Unfortunately, she often succeeded because someone spitting at them disgusts most people and it is extremely difficult to keep a straight face and ignore this behavior!
• Escape behaviors
  • Goal – to get out of doing something or going somewhere
  • Example – Lily does not want to do her schoolwork, so she starts throwing a tantrum to distract from having to complete her responsibilities.
• Automatic behaviors – actions that the student has seemingly no control over.
  • Examples of these behaviors might be things like arm flapping, rocking back and forth or various tics.

These examples of functions of behavior were negative, but children can be taught positive replacement behaviors accomplish their goals and have their needs met.

Because every child is different, we must approach each child in a manner specific to his personality and behavior.

Whenever we received a new student into our program, we spent a minimum of several weeks and sometimes longer “pairing” with the student: spending time with the child, observing his behavior, learning his likes/dislikes, what motivates him, what triggers him, etc. In order to work effectively with a child, we must know the child. Pairing also allows the child to get to know us and to develop trust and rapport. After weeks, sometimes months of counselors collecting data on a child, the lead clinicians then develop a treatment plan and set goals.

Even after a treatment plan is made, the plans are constantly being re-evaluated.

We can apply this concept to teaching music by remembering that progress may be slower than other students’ and will definitely look different than it does with other students. We have to consider all factors and set small, attainable goals. It may take a few months of pairing to develop rapport, especially if you only see the child once a week. Even after developing rapport, goals will look different. Rather than being able to work on technique or notes, you may have to spend time learning how to focus or learning how to sit or how to listen. You may have to use more hand-over-hand techniques or limit touch, depending on the child.

Side note: Contrary to popular opinion, children with autism do not all detest physical touch. Some do, but many do not. Some of the children I worked with were extremely affectionate and craved physical interaction with others. Some loved to hold hands and give hugs. Some of them had issues with pressure: weighted vests were comforting to them, or some did not seem to have the same awareness of how hard they were touching (i.e. rather than giving a simple, appropriate high five, some would smack your hand very hard without being aware that they had done so.) Some children would smack themselves in the face or hit themselves in the head.

Sometimes the only thing I can praise a child for is, “Thank you for trying,” “Thank you for sitting nicely,” or “Thank you for listening and following directions.” That’s ok! Each child works at his own pace. At the autism school, we had children completing algebra while others had goals such as learning how to microwave food or how to fold laundry because they were on completely different levels of functioning. A good teacher is constantly re-evaluating and working to create an atmosphere of acceptance, nurture, safety and love to foster learning. Rather than expecting a child to change, we must be willing to be flexible and adapt our methods to find what works for the child. For example, children with ADHD will probably need more wiggle breaks. Providing choices is always a good option for any children regardless of level of functioning.

Some have argued that children can learn music up to the ability of their language skills. I tend to disagree. I believe that minimally a child can learn music up the ability of his language skills. I say this because music is a universal language that anyone can speak. Music may very well be the outlet that sets a child free to communicate!

At the beginning of each school day at the autism school, we would have “morning meeting” where all the students would gather in the common room after breakfast. We would discuss the calendar and the weather, and then the children would pick out favorite songs to sing/dance to. Most popular requests included, “What does the fox say,” “Cupid Shuffle,” and “Who let the dogs out?” Typically, morning meeting was the time of day when I saw the children exuberate the most joy. Looking back on my time working there, I wish I had made the connection and pushed for more musical involvement. Hindsight is 20/20, I suppose.

When I received an opportunity to attend teacher training at the Suzuki Institute in Philadelphia, I could not pass it up and ended up leaving my job at RAP (Rivermont Autism Program) to become a Suzuki piano instructor. I have faith that my experiences both working as a day treatment clinician, as well as a counselor at RAP will prove useful during my teaching career. If you have any questions, please don’t hesitate to contact me; I would love to chat with you or to address more specific topics to the best of my ability.