9 ways to stimulate social and emotional development in your child with ASD: A Marte Meo Perspective
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9 ways to stimulate social and emotional development in your child with ASD: A Marte Meo Perspective

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When your child is diagnosed with a developmental disability like Autism Spectrum Disorder (ASD), it can generate an array of emotions in a parent; anger, fear or anxiety. Perhaps even relief that there is finally an explanation for your child’s struggles.

Parents then want to know what they can do to help, and what it might mean for their child’s future.

As a parent, you want what is best for your child. You want your child to learn to speak, communicate and make friends. Above all else, you want to develop a close, connected relationship with your child.

A diagnosis of ASD can make this very challenging.

Autism Spectrum Disorder refers to a group of neurodevelopmental disorders which includes Autism, Asperger Syndrome, and pervasive developmental disorders.

Symptoms can vary from child to child, but the condition is often characterized by ongoing difficulties communicating and interacting with other children and adults, repetitive behaviors and limited interests. [5,7]

It affects one in 68 children, with boys 3-5 times more likely to develop ASD than girls. [5]

As a parent you may feel the diagnosis of Autism and ASD focuses on your child’s deficiencies, what your child is not doing. Following a diagnosis, parents often seek education about the condition and practical advice on how to apply the theories in everyday life with your child. [6]

This article will examine how parents can connect theory to practice, and more importantly, how to find a connection with your child.

As a trained practitioner in Marte Meo, I’d like to share some of the key concepts of the program and how you can apply them to daily interactions with your child. It will guide you on how to use your relationship to support your child’s social and emotional development.

Common struggles for parents of children with ASD

One of the most challenging aspects for parents of a child with ASD is communication difficulties. Poor communication places strain on relationships and leave both the parent and child feeling frustrated and misunderstood.

There is more to communication than talking and listening. There are subtle non-verbal nuances, and underneath effective communication is the need for a genuine connection, a sense of togetherness.

This is what parents may feel is missing with their child with ASD.

Parents want their child to learn and meet developmental milestones, but they also want to build a relationship with their child.

“Children develop and grow in interaction with their caregivers” [3]

There are many forms of interventions for children with ASD that do a great job of targeting language, behavior and social skill development.

But what is the one thing that all children need? A secure attachment.

They need to feel secure, safe and connected to parents and caregivers. Your relationship with your child is THE most important intervention you can give your child.

What is Marte Meo?

The Marte Meo program was devised in Holland by Maria Aarts more than forty years ago. It became a leading intervention program in northern Europe and has found its place in the United States, United Kingdom, and Australia.[1]

Marte Meo translates as “on one’s own strength,” and this is the central focus of the program. It looks at what the child and parent can already do rather than what they are not doing. [1]

The program primarily uses video footage to “show” the parents what they are doing well and identify areas for improvement.

In 1976, Maria Aarts was approached by a mother of a child with Autism. The mother said to Maria “I would love to be able to have the kind of contact you have with my son.”[2]

At this moment, Maria realized how desperate parents are to learn the skills to connect and support their child. Professionals are trained and possess the knowledge and skills to work with children with ASD, but often the knowledge and skills are not transferred to the parent.

Maria created the program to bridge the gap between theory and practice and for parents to learn the basic communicative skills to stimulate their child’s social and emotional development. Marte Meo focuses on the individual connection moments between parents and children that occur a hundred times a day. [1]

Marte Meo is typically used with problem behaviors such as:

  • fussy eating
  • poor sleeping
  • and aggression

It has been applied to children with developmental disabilities and people in aged care facilities.

How is Marte Meo useful for parents of children with ASD?

Marte Meo focuses on ordinary daily moments between a parent and child.

It does not involve complex behavioral interventions.

It’s about extending the skills you already have as a parent and refining them for a child with special needs.

It moves away from the pressure for parents to ‘teach’ their child and moves toward supporting parents to be emotionally present and sensitive to the signals of the child.

Parents with a child with ASD may feel they aren’t doing enough or that there is a lot of focus on what their child is NOT doing. The Marte Meo approach focuses on good behaviors of the child and strengths of the parent.

This creates a good feeling between parent and child where a connection can be fostered. It develops trust and with trust comes cooperation.

For the child, it helps build their sense of self-image, and from this, self-regulation will soon follow. [2]

Parents are often told theoretically what areas of development need to be strengthened in their child, but they are not provided with the specifics of how to support their child on a daily basis. [1] Marte Meo delivers this information to parents in a clear and practical way.

Key points:

  • Marte Meo is a strengths-based approach to parenting
  • Parents need to be parents, not teachers

The Core Concepts of Marte Meo

Marte Meo practitioners are encouraged to work with parents using video footage.

A short film of 3-5 minutes with a brief interaction between parent and child is used. Then each moment is broken down by practitioner pointing out the moments when a parent fosters the child’s social and emotional development.

Maria breaks the program down into three easy steps, known as the 3 W’s. [1]

  • When: When your child packs away their toys
  • What: You say “that’s so helpful when you pack away your toys in the box. Thank you.”
  • Why: This is important as it shows your child you appreciate them, you take an interest in them, and you name what they have done

At the end of the session, the practitioner identifies one area of development from the footage, also known as a ‘missed opportunity’ that the parent can practice until the following meeting.

Some parents may feel silly commentating on every aspect of their child’s life, but with practice and using a conversational tone, in time it will become more natural.

The Key points of the 3 W’s

  • When your child does this…
  • What you can say is this…
  • Why is this important?

Nine ways to stimulate social and emotional development

1. Don’t ask too many questions

Children can feel overwhelmed by the constant barrage of questions from parents.

They may feel pressured to answer correctly, or they may not have developed the language to express the way they are feeling, thinking or behaving.

This is often the case in children with ASD.

Rather than questioning what the child is doing, parents can state observations instead.

For example look how these questions may play out with a parent and child with ASD.

Parent: “What are you playing with?”
Child: “Train.”
Parent: “What are you doing with the train?”
Child: “Driving”

It doesn’t create the open dialogue as hoped by the parent. Let’s look at how a parent can use statements to instigate conversation instead.

Parent: “I see you’re playing with a train.”
Child: The child may not respond, but will know you’ve shown an interest.
Parent continues: “Oh, it’s a red train, and it’s driving along the tracks. I wonder where the train could be going.”
Child: “It’s driving to the park!”

To encourage a child to learn, sometimes parents can ask too many questions.

If a child does not yet know their colors and you ask them what color the train is, then you set them up to fail. By naming, “this is a red train,” it provides information and language to the child about what the object is, the color and associated words. With repetition, the child will learn to associate the color red with the word red.

When you hold back on asking questions, it allows space for a child to speak, for ideas to flow and to follow their initiatives.

Key points:

  • Use statements not questions

 

2. Name what you and your child are doing [1,2]

This is known as ‘naming initiatives’ in Marte Meo.

Children with ASD have difficulties developing words connected to actions, so they may feel excluded from activities or other children may see them as unpredictable.

Parents are encouraged to put words to actions for them, but first, you must model this by naming your own initiatives.

This means when you have an idea, such as deciding to put on the kettle, you can name this initiative by saying aloud, “I am going to the kitchen to put on the kettle for my tea.”

This is important as it not only ensures your behavior is predictable, but the child also learns words connected to actions. It builds language development and encourages them to take a social interest in what other people are doing.

To build on this, you name the initiatives your child makes too. For example, “Oh you’re playing with the blue car.” It helps the child to identify their ideas by putting words to them.

It may sound simple, but it is an essential step in communication. Children who can name their initiatives and be predictable will be far more attractive to their peers.

They may say “I’m going to play in the sandbox,” and other children will think, “that sounds fun, I want to play in the sandbox too.”

On the other hand, if a child wanders off and plays in the sandbox without saying anything, then it doesn’t open up the opportunity for other children to be involved.

Key points:

  • Name your child’s actions
  • Name your actions

3. Name what you and your child are feeling [1,2]

Empathy develops when we can identify and understand what another person is feeling, and when we connect with that emotion within ourselves.

For example, if you have a friend who has just lost their dog to an illness, then you will feel sad.

You may know how awful it feels to lose a loved one, and it is not nice to see your friend sad.

These early communication moments learned in childhood help people identify the feeling of grief or sadness in another, as well as the feeling within yourself.

These skills do not come naturally for a child with ASD. They need a lot of support to develop them.

Some adults find it difficult to name their emotions, and this may take some practice. Saying it aloud will help your child understand feelings on a verbal and non-verbal level.

To begin with, you need to make the emotion BIGGER.

For example, saying loudly, “I’m feeling so frustrated that I can’t get this lid off the jar.” Exaggerate the non-verbal cues too by frowning and tensing the shoulders.

Naming your child’s emotions is important too.

For example, “Oh the tower fell over. You feel disappointed.” Reflect back their feeling through your facial expressions so they can see what disappointment looks like as well.

This is where the ‘don’t ask too many questions’ rule is imperative.

If a child does not have the language to express their emotions, then it is not fair to ask them ‘what is wrong?’ or ‘how do you feel?’ You have to name it for them.

Even if you’re unsure, just guess! You don’t have to get it right, as long as there’s a dialogue happening about feelings.

It’s also essential to name positive emotions too.

When you notice your child enjoying a cake, then say “you’re enjoying the cake.” It helps the child to connect with that pleasant feeling of ‘joy’ with the word ‘enjoy.

‘ With repetition, the child will learn this nice feeling is joy and can learn to label their feelings too.

You give the child the words to express themselves.

Key points:

  • Name what your child may be feeling
  • Name what you are feeling and speak them aloud

4. Name what other children are doing or feeling [1,2]

This involves tuning in to non-verbal communication.

Children can be taught to tune into other people’s non-verbal signals by naming the emotions of other children. “Nina feels scared when you push her out of the way.”

This helps a child with ASD to develop empathy and to respond to the other children’s emotion.

Maria calls this “lifting up the social information.” It can be used conversationally during moment-to-moment interactions.

Your child may not notice that Nina is scared, so you need to make it bigger. This helps them realize there are other children in the world. [2]

When children can understand and enjoy playing with other children, they tend to get better at dealing with frustration.

Key points:

  • Highlight what other children are doing or feeling
  • Lift up the social information

5. See the world from your child’s perspective

This is such an essential skill in understanding your child. It can be as simple as following your child’s gaze and stating what you see.

When a baby looks up at the ceiling, you can gaze upwards and say, “oh you’re looking at the light.”

This not only supports future language development by identifying the object, but it also provides a connection moment.

The baby feels understood at that moment.

This same principle applies to older children too. When you take an interest in what interests them, it fosters their self-esteem.

Key points:

  • Follow your child’s gaze and state what you see

6. When to LEAD

In the busy lives of families, parents can sometimes get too focused on challenging behaviors and become frustrated when their child doesn’t cooperate.

In Marte Meo, Maria encourages parents to take the lead in certain situations, and to follow in others.

In situations such as dinnertime and bath time, a parent is encouraged to lead and set structure. This involves telling the child what they can do (rather than what they are not to do).

For example, when it is time for a child to have a bath, this is where a parent needs to take the lead.

To set the structure, you set up the rules beforehand and outline what the child is to do. You can that by saying to the child: “first you will get undressed, and then you will get into the bath. You can play with your toys, but the water has to stay in the tub. You will have ten minutes to play, and then it is time to towel off and dress in your pajamas.”

This gives the child an idea of what is expected of them. It provides consistency and predictability.

When you notice the child cooperating, then highlight this. “You’ve done so well to get undressed and to get into the bath as I asked.”

You can imagine how different the scene plays out when a parent says,”Okay you have to get in the bath right now, and I don’t want water going all over the floor. And don’t run off when I’m trying to dress you.”

When a favorable structure is provided to the child, it makes the activity more pleasant, and the child is more likely to cooperate.

Key points:

  • In leading moments, set structure for the child

7. When to FOLLOW

There are times for parents to take the lead, and there are times for parents to take a step back and follow.

In Marte Meo, this is where parents are encouraged to “sit on their hands.”

In particular, this applies to play time, as this is when children are free to explore ideas (obviously where it is safe to do so) and take their own initiatives.

If a child is stacking a tower, it may be tempting to say, “why don’t we put a little person on top of the tower?”

But this is the parent’s idea, not the child’s.

This often occurs because the parent wants to feel connected to the child and to be involved in the play.

A parent can do this by following their child, and by naming the child’s actions and initiatives:

“You’re building such a high tower, look how steady you’re holding your hand.”
“Oh, you’ve balanced a car on top, what a great idea.”
“I can see how well you are concentrating. You are really enjoying this.”

Again, the ‘don’t ask too many questions’ rule applies here. Questions interrupt the flow of thought and restrict the range of responses. Naming statements build on a child’s initiatives and helps them grow and elaborate, even if they don’t have the words to connect them just yet.

It is vital for children to learn social skills, but it is also vital that a child has a right to be themselves.

Allow your child some space to be who they are by following their initiatives. It will allow you to understand your child better and gain some insight into their internal world.

You may find it helpful to capture a 3-5 minute film of your child playing (or you playing with your child). Playback the footage, and stop it every few seconds and examine what it is your child is doing. Wonder what they might be thinking or feeling in that moment.

Key points:

  • Follow your child’s lead as they play
  • Name your child’s initiatives
  • “Sit on your hands”
  • Avoid asking questions

 

8. Connection before action

Often parents who have a child with ASD are concerned about their child’s lack of eye contact.

Teaching a child to have more eye contact can sometimes be the focus of behavioral interventions for children with ASD.

Maria says “eye contact is the end result of feeling togetherness.” [2] So when there is a moment of genuine connection between you and your child and the child feels you are with them, then the child will be more likely to look in your direction.

Marte Meo encourages parents to wait for a child’s reaction and then adjust your pace as needed.

We can use the earlier example of bath time to explain this point: You can kneel down and address your child by name. Wait for the child to look up, or at the very least, pause in their play. Know that you have their attention.

This is a connection moment.

It may be the slight lift of a chin in your direction, perhaps not eye contact, but that is okay. You wait for the child to be ready, and then you move on to the next step. “Son, in five minutes, it will be time for a bath….”

When action moments are slowed down, the child becomes an active participant in decision making.

Key points:

  • Connection before action moment

9. Reinforce your child’s language initiatives

Focus on the moments your child makes language or social initiatives.

When they use words, create a social connection or use eye contact; really celebrate this.

“Oh, it was really kind when you moved along the seat to let your sister sit down.”

When your child says something, listen and confirm what is said. By answering them, you can initiate a dialogue with them.

Key points:

  • Notice and celebrate when your child shows positive social behavior or good language

10. Bonus tip: Don’t be too hard on yourself!

Parenting is a challenging job and caring for a child with ASD can make your job even more difficult.

This mother who worked with Maria summed up the experience of growing and challenging yourself as a parent very nicely:

“Now I learn so much from having such a special child. There is a choice: you can put your hands in front of your eyes or use the situation to develop yourself further. It takes a lot of energy. Not only at home but also in other situations. Nothing happens by itself.” [2]

There are always areas to develop and grow as a parent, but we mustn’t get too caught up in our failures. No parent is perfect. It is just not possible or necessary. Reflection is a crucial parenting skill. If you can take a few minutes at the end of each day to think “well I didn’t handle that so well,’ and to think about how you may do it differently the next day, then your child will benefit greatly.

Key points:

  • Parenting is hard work
  • Reflect and continue to grow as a parent
  • Celebrate progress!

Conclusion

Marte Meo is a developmental support program that is applicable across the lifespan, but has a unique application to children with ASD.

It provides small, concrete steps parents can take to stimulate their child’s emotional and social development.

There are so many wonderful interventions and resources available for parents with ASD, but Marte Meo helps parents build on the skills they already have and use their relationship to support their child’s development.

Further Resources

For further reading about Marte Meo, or to find a trained practitioner in your local area, visit www.martemeo.com

References

1. Aarts, Maria. (2008) 2nd ed. Marte Meo Basic Manual. Aarts Productions: The Netherlands

2. Aarts, Maria. (2012) 2nd ed. The Marte Meo Program for Autism: Six information sessions on how to stimulate social and emotional development. Aarts Productions: The Netherlands

3. Osterman, G., and Moller, A., and Wirtberg, I. (2010). The Marte Meo Method as a means of supporting new adoptive parents. Adoption and Fostering, 34, (2).

4. Autism Spectrum Disorder. (2018) Mayo Clinic. Retrieved from: https://www.mayoclinic.org/diseases-conditions/autism-spectrum-disorder/symptoms-causes/syc-20352928

5. Autism Spectrum Disorder (ASD) (2018). National Institute of Mental Health. Retrieved from: https://www.nimh.nih.gov/health/statistics/autism-spectrum-disorder-asd.shtml

6. Murphy, T., and Tierney, K. (2014). Parents of Children with Autistic Spectrum Disorders (ASD): A Survey of Information Needs. National Council for Special Education Research Initiative. Retrieved from: http://www.ncse.ie/wp-content/uploads/2014/10/Parents_of_children_with_ASD.pdf

7. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

About the Author Lauren Keegan, Registered Psychologist

Lauren Keegan is a psychologist with a special interest in perinatal and infant mental health. She has over 10 years of clinical experience working with parents. When Lauren isn’t working or writing she’s building Lego towers with her toddler and practicing the fine art of negotiation.

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