Treating autism differently
I have always loved working with children and teenagers with autism. During my expatriation in the US, I discovered the Son-Rise Program, a method created by a couple for their little autistic boy. This article shares my experience with the Son-Rise Program and explains its principles and objectives.
Credit : www.barryneilkaufman.com
In January 2016, I moved from France to Boston. I was motivated to work as a psychomotor therapist even though this profession does not exist here. After a few months of research, a video appeared in my Youtube suggestions: it was about two tween brothers whose parents had built a small house in their backyard in order to give them an original therapy, the Son-Rise Program. As the video went on, I connected to the attitude of the professionals and to their vision of autism. As soon as the video ended, I was on the website of the Autism Treatment Center of America registering to their training for parents and professionals called Start-Up. In June 2017, I drove to Sheffield (MA) to take one week of training with 85 parents from all over the world. During these 5 days spent in the middle of beautiful mountains and forests, we studied the Son-Rise Program's principles and techniques thanks to very special teachers: the first Son-Rise kid, his sister and their parents, who created the Son-Rise Program. When I came back from the Start-Up, I started to apply everything I had learned with my little patients, autistics or not and I saw a huge difference during my sessions! I decided to register for another week of training in November called New-Frontiers. This program focuses on boosting our creativity to introduce new games ideas to our children and helps us get acquainted with the Developmental Model which allows parents and professionals to plot the child to see what will be the next goals. A few months later, I came back to Sheffield, this time with a French couple and their son for a Son-Rise Program Intensive: the young teenager works all day with a member of the staff while his parents take classes, speak about their expectations, their difficulties, etc. At the end of the week, this young boy looked more at us , said a few words when he could only make sounds on Monday, was able to participate in a game for 35 min instead of 3 min at the beginning of the week, was more flexible and accepted new things easier. I continued (and still do) to use the Son-Rise Program in my sessions and I also translated several documents for a French non-profit, Optim' Autisme, who offers Son-Rise trainings in France. I will participate to the Maximum Impact program in 2019, maybe in France this time, and other families already contacted me to go with them to take the Intensive program.
Where does the Son-Rise Program come from?
In the early 70's, Barry Neil Kaufman and Samharia Lyte Kaufman became parents of a little boy named Raun. Quickly, they realised that he developped differently than his two big sisters: he did not answer to his name, he cried a lot and spent hours spinning plates and looking at the water going down the toilets while flapping his hands and rocking back and forth. Doctors announced that Raun is an autistic child with an IQ below 30, adding he will never talk or communicate, he will never graduate from college, he will never have a job and at best, maybe he will be able to dress by himself and use a spoon to eat. When Barry et Samharia wanted to find a little glimpse of hope, doctors only stated definitive sentences. The couple decided to turn their backs to every institutions and promised themselves that they will always see the best in their boy. They created a stimulation-free environment where Raun would feel safe, loved and accepted as he is. Samharia started to imitate his autistic behaviors, trying to live the same thing Raun was feeling. She joined him during months, not waiting for anything back. Slowly, Raun looked at her and understood she was there for him, she loved him and tried to understand him. A bond was created. The more this bond grew and strengthened, the more Raun went out of his world and interacted with the people around him. That was the beginning of the Son-Rise program. A few years later, Raun had no traces of his former condition. Today, he gives lectures everywhere in the world to talk about his experience and the story of the Son-Rise Program. Barry et Samharia founded The Option Institute and The Autism Treatment Center of America in 1983 where they teach other parents and professionals the method they created, the Son-Rise Program.
Son-Rise Program principles
The founders of the program use this little phrase to describe the Son-Rise: "They show us the way in, we show them the way out". To join the child in his/her world, we need to use several keys: the first one is the attitude.
The goal here is to find a way to see autism not as a bad thing but as a good thing: in this over stimulating world, that can be anxiety-provoking, my child or my patient found some ways and habits to take care of him/herself, to calm down, to feel safe. These habits indeed are not "socially acceptable" ways, but that is the way it is. Having a Son-Rise attitude, it is being able to feel okay with the fact that the child has stims (or as we call them in the Son-Rise Program, isms), that they could start screaming in the street, that they use us only as a way to obtain something, etc. It is also being able to be amazed ten, twenty, a hundred times for a glance, an affective contact, a small noise. These children must feel they are loved and accepted as they are, that we are not trying to change them, in order for them to trust us and to want to come to us.
The second key is joining. When the child is doing a repetitive behavior, does not look at you or does not talk directly to you, is self-centered, you are going to join him or her in their world. You will stay a few feet away from the child, your face a little bit lower than his/hers so it is easier for them to look at you, and you do the same thing the child does, while keeping your Son-Rise attitude (everything is all right, even though my child or my patient does not look at me, I accept that and I show him/her I love them by joining them in something they love to do.) Keep going as long as the child does not look at you. You could spend 45 min, 1 hour and even more lining up cars, picking up invisible dust, singing and rocking, biting your hand, running from one wall to the other or talking about the evolution of trains since the first steam locomotive... We could think of this as a lost of time especially in therapy, but it is actually the opposite: this is the time where you create a bond with the child and give a message of love and acceptance. And one day, the child will stop and look at you, or will sit next to you and that is the occasion to use the third key: celebrate!
You can celebrate in a variety of ways: "Thank you for looking at me!", "I love your eyes!", you can sing, make a silly voice, a silly face, whisper, dance, tickle, squeeze... The goal is to show your child or you patient you are fun, interesting, helpful! Of course, choose a kind of celebration adapted to the children, do not speak loud if they are noise-sensible nor move fast if they are easily scared by sudden moves. Once you have celebrated the child there are two different scenarii possible: either the child goes back to his autistic behavior and the adult goes back to joining, or the child keeps a visual or physical contact and the adult tries to introduce a game.
The fourth key is to use your kid's motivations! We link our goals with the children's motivations. This principle is different than the traditional reward principle. We do not present the motivation as an answer to an "adapted behavior", we use them to help us create this behavior. For instance, your child or one of your patients loves squeezes and your goal is for her to say one word. When she looks at you, you celebrate and then give her some squeezes on the arms or the legs, saying "squeeze; squeeze; squeeze" in order for her to connect the word with the action. After several minutes of this game, if she is still invested in the relationship with you, pause, ask her to say "squeeze" and leave her enough time to process this request. If she does a sound, even though it is nothing like "squeeze", celebrate by giving her quicker or deeper squeezesand if she does not do anything, keep the game of squeezes going, unless she goes back to an autistic behavior in which case you will join her. You want your child to develop imaginative play and one of his favorite things is letters and numbers? Dress up the letters with playdough, create a decor with cardboard and take the letters to a picnic or to the beach and see if your child joins you in this game. Your little patient loves everything that is related to the circus and you want to increase the time she spends interacting with you and interested in a game? Your therapy room becomes a circus ring, you are a clown or an acrobat, stuffed animals walk on the rope, animal figurines create amazing pyramids, etc. You can see on the picture above what a mom created for her son passionate by trains: she wanted him to be potty trained so she transformed her bathroom! Taped tracks are going from his room to the bathroom and the mom said to her son he needed to "fuel up" the train!
It takes a little bit of creativity and just try! Some ideas will fail but other will have an amazing success!
Fifth and last key: give control to your child. Of course, you cannot let your children decide every aspects of their lives! But when they are in the playroom or in the therapy room during a Son-Rise session, we try to be the most flexible we can and avoid having to say no. The objective of the Son-Rise Program is to build a relationship based on trust so that the child could easily reach out to the adult. Saying "no", "you cannot do that or have that" sends a bad representation of the world and leads to conflicts that could have been avoided. Most children with autism need to control a lot of things: from the color of the clothes they wear to the road you need to take to go to school and including the number of stuffed animals on the bed... In his book Autism Breakthrough, Raun Kaufman writes: "If you want your child to be less controlling [...] you have to give your child as much control as possible. Have you ever hugged your child when she didn't really want to be hugged [...]? Have you ever physically moved items that your child was playing with, [...] to show her the "right" way to play with them? Have you ever pressed your child to [...] say "hello" or "thank you"? Have you ever held your child so that you could brush her hair, wash her face, etc. while she was trying to get away? It's totally okay if you've done any or al these things. [...] You may address the issue in the moment (clean teeth, brushed hair, etc.) but you compromise interaction and learning long-term because you get a child who is not only more controlling but also associates learning or doing something that you want with coercion and unpleasantness."
Main focuses of the Son-Rise Program
With the Son-Rise Program, we see autism not as a behavioral problem but as a social-relational problem. To work on the social and relational aspects, the Option Institute created the Son-Rise Developmental Model. We focus on 4 fundamentals:
Interactive attention span
Eye contact and non- verbal communication
Each of those 4 fundamentals is broken down in 5 stages, each of them having precise goals. For instance, in stage 1 of eye contact and non-verbal communication you can find objectives like: Looks at others to start/continue an interaction or Physically moves other to get what he/she wants. In flexibility stage 3, goals like: Shows an interest in another's activity as well as Takes turn during an activity.
It is on this Developmental Model that parents and therapists can rely to see where the child is and what his/her next goals.
What does a Son-Rise session look like?
Sessions last for about 2 hours with a parent, a professional or a volunteer. We prepare the session before by reminding us what are the goals and the motivations of the child as well as thinking of a new game to present to the child.
Once the session starts, we conform to the child: if he is in his world, we will do some joining (sometimes during up to 2 hours!) and as soon as we have a physical or a visual contact, we celebrate and begin a game or an activity related to the child's motivations. If the game continues and the child is still interested in us, we can add something new to work on one or several goals. If the child goes back to a self-centered activity, the adult goes back to joining. We keep this going until the end of the session!
As you may see, the Son-Rise Program is my favorite thing to do when working with children with autism. I think it is a sound and logical approach, child-centered, respectful of the child's rythm and individuality. It is totally compatible with psychomotor therapy and it is useful even with non-autistic children!
As a professional, I have some reservations though: the trainings are really expensive and until recently they were taking place only in Sheffield (MA). Interested parents would have to spend a lot for the travel and the training. There are no longer professional trainings to become a child facilitator and the few existing all work in Sheffield. Another aspect I dislike is the marketing campaign about the Son-Rise Program is based on the notion of miracle. No, Son-Rise is not a magic and miraculous method. Surely a lot of children and adults have overcome their conditions and are now socially capable but that is not the case of every children and every adults who have tried the Son-Rise Program.
This article is only a brief summary of the approach and does not include every techniques and nuances. For more information, I recommend you read Raun Kaufman's book, Autism Breakthrough and go check their website:
I also would be happy to answer to any question by e-mail : email@example.com