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Developmental Approach to Problems in Relating and Communicating in Autistic Spectrum Disorders and Related Syndromes Stanley I. Greenspan, M.D. The Six Fundamental Developmental Skills Six basic developmental skills-we call them the six functional milestones-lay a foundation for learning and development. Children without special needs often master these skills relatively easily. Children with challenges often do not, not necessarily because they cannot, but because their biological challenges make mastery more difficult. 1. The dual ability to take an interest in the sights, sounds, and sensations of the world and to calm oneself down. Attend to multi-sensory affective experience, and at the same time, organize a calm, regulated state and experience pleasure. 2. The ability to engage in relationships with other people. Engage with and evidence affective preference and pleasure for a caregiver. 3. The ability to engage in two-way communication with gestures. Imitate and respond to two-way pre-symbolic gestural communication. 4. The ability to create complex gestures, to string together a series of actions into an elaborate and deliberate problem-solving sequence. Organize chains of two-way communication (opening and closing many circles of communication in a row), maintain communication across space, integrate affective polarities, and synthesize an emerging pre-representational organization of self and other. 5. The ability to create ideas. Represent (symbolize) affective experience (e.g., pretend play, functional use of language). This ability calls for higher-level auditory and verbal sequencing ability. 6. The ability to build bridges between ideas to make them reality-based and logical. Create representational (symbolic) categories and gradually build conceptual bridges between these categories. This ability creates the foundation for such basic personality functions as reality testing, impulse control, self-other representational differentiation, affect labeling and discrimination, stable mood, and a sense of time and space that allows for logical planning. This ability rests not only on complex auditory and verbal processing abilities, but visual-spatial abstracting capacities as well. These basic skills are not the traditional cognitive skills of identifying shapes, naming letters, and counting. They are not the traditional social skills of taking turns and sitting still. They are more fundamental. We call them functional emotional processes because they are based on early emotional interactions and they provide the basis for our intellect and sense of self, as well as the basis for such familiar skills as counting and taking turns. Three aspects of the child's world come together to influence how well he masters these functional emotional milestones. The first is the child's biology, the neurological potential or challenges that enhance or impede his functioning. The second is the child's own interactive patterns with his parents, teachers, grandparents, and others. The third is the patterns of the family, the culture, and the larger environment. A child's biological challenges influence his interactions with others. A child who is under-reactive to sound is unlikely to turn toward his mother's wooing voice. A child who is over-reactive to touch may shrink, or even shriek, when her father tries to hug her. A child confused by sounds or sights, or with an inability to plan actions, may become repetitive. It's easy to understand how these reactions can influence a child's development. If a child continually withdraws from his mother, the mother may understandably decrease the degree to which she tries to woo the child into loving interaction. She may feel confused and believe he prefers to be left alone. On the other hand, special understanding of a child's under-reactivity may enable a parent to work around the biological challenge to pull him into a relationship and begin interactions and communication. Very different trajectories are therefore possible. |
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