ISEC 2005

Inclusive and Supportive Education Congress
International Special Education Conference
Inclusion: Celebrating Diversity?

1st - 4th August 2005. Glasgow, Scotland

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The SHARE Innovation:
Sharing expertise in supporting young children with autism

Authors: Helen Marwick*, Adrienne Shaw**, Lisa Glashan**, Mary Hamilton***, Jeannie Hardie*** and Gilbert MacKay*

* University of Strathclyde
** South Lanarkshire Education Authority
*** Scottish Society for Autism

helen.marwick@strath.ac.uk

Abstract

The SHARE innovation was developed as a new type of service provision, which aims to add to the value of services for children with autism in their early years. Funded by the Scottish Executive, Special Educational Needs Innovation Grants Programme, it drew on the respective strengths of an education authority (South Lanarkshire Council Education Services), a voluntary organisation (Scottish Society for Autism) and a university (Strathclyde). It involved the appointment of home agency link advisers for families with children with autism, who operated both in liaison among families and local services and also as facilitators for developing children's communication and social interaction abilities.

It was in this second part of their role that the Joint-Play Intersubjectivity Assessment Method (JPIAM) was used. The JPIAM is a method of promoting and assessing active interpersonal engagement and communication between a child with autism and an adult interactive partner, which uses a setting of joint-play and applies a comprehensive category system of interpersonal understanding and interaction. The SHARE advisers also introduced the JPIAM method to the parents, in order that they could continue with its use if desired, and were instrumental in helping parents' uptake of the messages of intersubjectvity.

This paper outlines the highly successful recent application of SHARE in practice with a group of 18 pre-school children with autism and their families, and presents results on the effective facilitation and development of communication, social understanding and imaginative representation found for these children within the JPIAM sessions and reported also by their families in generalised contexts. The paper is written from the viewpoints of the participating professionals in order to highlight the benefits of multi-professional working and joined-up practice used in this approach.

Introduction

The SHARE innovation brought together the expertise of a range of professionals from South Lanarkshire Education Authority, The Scottish Society of Autism, and Strathclyde University to provide a new type of support for young children with autism and their families. The SHARE team included: a Specialist Speech and Language Therapist, a Pre-5 Outreach Teacher, six Autism Advisers, a Developmental Psychologist and an Educational Psychologist. SHARE autism advisers appointed by The Scottish Society of Autism were trained in the JPIAM approach, devised by Dr. Helen Marwick of the University of Strathclyde. These autism advisers worked with young children on the autistic spectrum and their families, who were referred to the project through the Speech and Language service and the Pre-school Outreach Teacher service of South Lanarkshire Education Authority.

Over the course of a two year project, 18 pre-school children and their families have been involved in the SHARE innovation with the children participating in weekly JPIAM sessions over a 16 week period. The children have shown gains in the areas of joint participation, shared feelings, communicative purposes and symbolic imagination, and in being able to read the intentions of others and adjust their behaviour accordingly. Parental and nursery feedback has been a further important source of information and evaluation and has revealed gains in the children’s social motivation and sociability outwith the joint-play sessions, including gains in pretend play, in language abilities, in planning and transition abilities, and endurance of these gained abilities. Many parents have successfully incorporated the joint-play method into their weekly schedule.

Overview of design and procedure

The SHARE project team met at regular intervals throughout the course of the project to plan and review procedure, to review progress and share information. Central to the SHARE innovation was the Joint-Play Intersubjectivity Assessment Method (JPIAM) (Marwick, 2001), which would be used to facilitate engagement and communication The earliest stages of the project involved presenting the JPIAM to all professionals involved and confirming the design of the project. Following presentation of the JPIAM method, short explanatory sheets were produced to inform parents about the SHARE innovation, which the Specialist SLT and Outreach Teacher could use in recruitment. It was agreed that all participating children would have a diagnosis of autism, ASD, or Asperger Syndrome, and that we would work with children with a range of abilities. The 2-year length of the project allowed us to offer a series of 16 weekly sessions to 20 children and families.

The referrals were in the majority made by the Specialist SLT and Pre-school Outreach Teacher, who introduced the project to parents and invited them to participate. They then introduced the adviser to the parents in an initial meeting where information about the child was discussed and the hopes that the parents had for outcomes from the project. This information informed the initial materials introduced in the joint-play session, preparation for the child for entering into the sessions and the transition from the joint-play setting to a subsequent activity. The adviser then set up the series of weekly sessions at a time suitable to the parents. 14 sessions set up with the child with 2 ‘transfer’ sessions where a parent also participated and the adviser transferred the approach to the parents. After each session the parents were given feedback on what had been achieved on the session. Further support for the parents was also offered by the adviser if required Three of the sessions were video-ed; the first session, one in the middle, and the last session with just the adviser and child (session 14). An interim review meeting with the parents took place around session 8 attended by the SLT, outreach teacher, autism adviser, with a final review meeting taking place after the final session.

After each joint play session the adviser used the JPIAM category system to assess the social interaction and understanding of the child and of themselves, and this information informed the planning of the next session. After the first sessions, and regularly throughout the range of sessions, consultation with the developmental psychologist took place to confirm the ongoing assessment and plan the subsequent sessions to respond to the developmental needs of the child. At the end of the sessions the advisers produced a final report for the parents summarising the achievements and progressions made by the child throughout the sessions and with recommendations for further joint-play activities, which the parents might like to continue with. This was presented to the parents in a special presentation pack with a copy of the video footage.

The JPIAM approach

Central to the SHARE innovation was the joint-play method, which would be used to facilitate engagement and communication The JPIAM was created by Dr Helen Marwick (Marwick, 2001), who provides a description of this method in this section.

The Joint-Play Intersubjectivity Assessment Method (JPIAM) was developed as a method for both the assessment and promotionof active interpersonal engagement, interpersonal understanding and communication, and shared imaginative representation between a child with autism and an adult interactive partner. It uses a joint-play setting with a pair of matched toy boxes for a series of interactions for pre-school children with autism with an adult partner, and applies a comprehensive category system of social understanding, imaginative representation and engagement for both child and adult.

The JPIAM reflects the fundamental importance of joint-play as a developmental process. In typical development joint-play i s entered into at an early age. Caregivers and infants of a few weeks of age match and imitate each other’s expressiveness (such as vocal pitch, tongue movements and facial expressions) with attuned focus and enjoyment, and move on to engage in more boisterous musical and action play where adults not only model actions and establish shared anticipations, but also contravene shared expectations about objects, events, feelings and ideas within positive affect to surprise and amuse the child (Trevarthen, 2001). As joint-play develops to increasingly incorporate actions and purposes with objects of shared focus, caregiver and child negotiate and anticipate ideas and intentions, cooperate in activities, and refer to objects which are present, and also to objects and events which are not present but in shared experience and shared memories. In this way, joint-play engagement with shared focus can be understood to underpin and facilitate sharing and understanding feelings, shared meanings, contingent and cooperative activity, interpersonal purposes, awareness of interpersonal intentionality in others, and conceptual and linguistic development (Stern 2000; Trevarthen, 2001) Symbolic play with young children is shown to be related to interpersonal motivations (Trevarthen & Marwick, 1986) and imaginative activity in toddlers is strongly supported by caregivers in joint engagement (Emde et al., 1997; Tamis-Lemonda et al., 1998) who adjust their play to the toddler’s level and facilitate more complex forms of play.

For children with autism, however, a lesser motivation to engage in playful activity with another person is observed (Trevarthen et al, 1998), which will reduce the child’s experience of joint-play, and thus, can be understood to alter the child’s social, communicative and imaginative development (Jordan, 2003; Marwick and MacKay, 2004). Correspondingly, r esearch indicates that the communication, social interaction and imaginative play of young children with autism can be markedly developed through interactive play interventions with a trained facilitating adult or older child (Libby et al, 1998; Beyer and Gammeltoft, 2000; Janert, 2000; Zercher et al, 2001; Sherrat, 2002).

The JPIAM is designed to provide a setting and context to encourage shared interpersonal focus, interpersonal contingency and cooperation, and motivation to engage with another person and develop playful interaction. The JPIAM recognises that interpersonal understanding, shared memories and expectations are built up over time, and so, is designed to be used as an intervention over a series of sessions.

The JPIAM structured setting for joint-play activities initially centres on the presentation of two toy-boxes, decorated to encourage sensory exploration, with one for the child and one for the adult. This provides an immediate visual and sensory focus to give an entry point into interaction,inviting comparisons, shared exploration, discoveries and recognitions. Inside each box are matched identical or complementary sets of objects conducive to promoting the different types of joint play found in typical development - expressive-attentive joint-play (such as contrasts in facial expression, voicing, pitch movements, singing, making and watching bubbles); co-operative goal-directed play, (such as blowing and bursting bubbles, building a tower together, give and take games, hide and find games, turn-taking sequences ); and joint imaginative play (such as using representational toy objects conventionally or symbolically, role play, and including a soft toy or doll as an additional representational animated participant). Within the three types of play the adult will be trying to achieve some specified aims such as engaging the child’s attention, and encouraging shared feelings, perspectives and expectations. Having a matched toy box for each participant also allows the adult to use a range of strategies to realise these interpersonal aims, such as, being able to join and imitate the child in interactions, to share and match focus, and model and develop interactions with the representational toys. The playful setting also enables the adult to achieve the aims by, for example, amusing and intriguing the child and by giving personal and interpersonal effectiveness to all expressiveness of the child.

Analysis and categorisation of the interaction and types, and sub-types, of joint-play for both child and adult involves a narrative account and categorisation by the adult partner using the JPIAM category system. The category system is designed to reveal and recognise interpersonal engagement and motivated interpersonal focus, interpersonal contingency in interaction and reciprocity in engagement, the range and extent of interpersonal purposes, shared understanding, interpersonal anticipation, communicative effectiveness, interpersonal representation, and awareness of another’s perspective for both the child and the adult, and, when used longitudinally, to analyse and evaluate progress.   The main JPIAM category system comprises 51 categories of engagement and 8 of non-engagement. Assessment information in relation to both the child and the adult is fed forward into subsequent sessions to inform choice of toys and activities attempted, and focus for particular aims and strategies. The JPIAM is, in this way, both an assessment method and an intervention.

The role of the Specialist Speech and Language Therapist and the Pre-5 Outreach Teacher.

The Specialist Speech and Language Therapist (Adrienne Shaw) and the   Pre-5 Outreach Teacher (Lisa Glashan) from South Lanarkshire Education Authority, provide details of their role in SHARE in this section.

Participants

Overall, twenty children and families from across South Lanarkshire had some involvement with the 2-year SHARE programme. Nineteen children completed the course and one family withdrew at 4 weeks. One family withdrew from the project after completing the course. The participant group, therefore, numbered 18 children and families. The participant group included two children from the same family.

All of the children involved had a diagnosis of Autistic Spectrum Disorder (ASD). Nine children had been assessed as having ASD at the regional paediatric centre (Scottish Centre for Autism). Nine children had been assessed by community autism teams from either Glasgow or South Lanarkshire. All the teams used the WHO ICD – 10 criteria (WHO, 1992) as a framework for diagnosis. No other specific criteria were applied to the children, and all had different presentations in the areas of language development, cognitive functioning and sociability. Sixteen of the participants were boys and two participants were girls.

This project was aimed at pre-school children with ASD. The ages of children involved ranged from age 3 up to 5 years. Due to a waiting list, 2 of the children started Primary 1 midway through the programme.

13 of the children had a diagnosis of autism

6 of the children were considered to have additional learning problems.

4 were diagnosed as having high functioning autism. Only 1 of the children had a diagnosis of Asperger’s Syndrome.

Children were accepted onto the programme regardless of what current or previous interventions they were involved in. 3 had previously attended the pre-school programme at the Scottish Centre for Autism. 11 had attended a Hanen ‘More than Words’ workshop (Sussman, 1999) delivered in Lanarkshire. 4 families were undergoing private programmes at home.

Referral process

An open referral system was in place. The majority of the referrals came from the South Lanarkshire partners in SHARE (Specialist Speech and Language Therapist and Pre-five Outreach Teacher). Other referrals were made by local Speech and Language Therapists.

One parent, whose son had been involved in the project, requested that her newly diagnosed daughter be referred. No referrals were turned down during the duration of SHARE.

Following completion of the project, several children were identified who would have benefited from this type of intervention.

Sign Up

Upon referral, parents were offered a preliminary visit with the Specialist SLT and Pre-5 Outreach Teacher. The child was not usually present at this stage. During this visit the intervention was explained to the parents in detail. They were informed about the nature of the intervention, the level of commitment required, organisation and their own/others’ involvement. If the parents were interested they were asked to sign a consent form agreeing to their child’s participation in the project.

Video consent

The use of video was discussed at this stage and it was explained that 3 video sessions would be carried out: one at the beginning, one midway, and one in the final week. If in agreement a video consent form was signed at this stage.

Child Information Sheet

Information was collated about the child. This information was passed on to the relevant Adviser. In order to shape what initial toys/materials the adviser could bring to the first session, practical information was also gathered at this stage. Other information, where available, such as the child’s diagnostic reports or speech and language therapy reports were gathered.

Assessments

Parents were asked to complete the ‘Pragmatic Profile of Everyday Communication Skills in Children’ (Dewart and Summers, 1995).

The parents were supported in this if required by the community SLT or the SLT attached to the programme. The assessment was administrated prior to SHARE beginning and upon completion. Findings comparing the child’s communication ratings on the profile are in preparation.

Meeting the Adviser

Following the preliminary review, the adviser was taken out to the home to meet the parents prior to beginning the programme. This was an informal meeting to finalise individual arrangements.

Review Process

A review system was agreed where the parents, adviser, SLT, and Outreach Teacher met to review all aspects of the programme at a midway point, and at the end of the programme. Relevant changes were made at this stage where necessary, and feedback was sought and provided to local professionals.

The role of the SHARE Autism Advisor

Six autism advisors were provided through the SSA for this project. Two of these advisers Mary Hamilton and Jeannie Hardie describe their involvement in the project in this section

Overview of implementation of the SHARE approach by the Autism Advisers

Fitting into approximately one and a quarter days per week, per child, the role of the Autism Advisor delivering the SHARE programme to pre-school children with ASD involved not only weekly preparation, play-sessions, and documentation, but also weekly feedback and liaison with the parents and regular liaison with the other partners involved in the project.

The Autism Advisors induction into the SHARE project began with dissemination meetings involving all the partners. Training in the JPIAM was given by Dr. Marwick. Once specific children had been identified by the Specialist SLT and Pre-5 Outreach Teacher involved in the project, joint initial meetings with the families took place. This gave the parents the opportunity to meet the Autism Advisor who would be working with their children over the following 16 weeks; a relationship which in some cases extended to follow-up correspondence and photographs of the children doing important ‘milestones’ such as the first day at school.

These initial meetings with the families focused on introducing the SHARE process; the roles of the involved parties; timescales and durations, and gathering information on each child. Key areas of interest here included the child’s interests and motivators; known triggers of upset; any sensory sensitivities; levels of communication; any augmentative forms of communication used; expected tolerance of both Autism Advisor and session duration, and identifying ways to successfully put closure on each session.

Also discussed was the advisory role of the SSA’s Advisory and Consultancy Service, which families could access during or after the SHARE project if required. For some parents this was a valuable aspect of the project, while for others this level of support was not required.

Once the play sessions were underway, the parents could receive verbal feedback after each session if desired. From an advisor’s point of view, it was preferable for this to take place by phone once the documentation for that session had been completed; information for this relied on memorizing around 40 minutes of intensive interaction and activity, which could all too easily be lost if not documented straight away. Furthermore, from the child’s point of view, it was felt that it could be confusing if the Advisor’s role changed from ‘play partner’ to ‘adult’ conversing solely with the parent. This said, in certain circumstances it was felt that parents would particularly benefit from direct feedback, reassurance and Advisory support, and this was able to be arranged immediately after the sessions.

The documentation itself involved detailed analysis of the session, using the specific categories. This typically took 3 hours to complete and would be followed by forward planning and preparation for the following session. In addition to the verbal feedback, the parents were also offered written information on each session. This tended to take the form of a narrative. Depending on parental preferences, either written, verbal or both forms of feedback were supplied.

After the first session, and regularly throughout the range of sessions, consultation with the developmental psychologist took place to confirm the ongoing assessment and plan the subsequent sessions to respond to the developmental needs of the child. The first, seventh and fourteenth play session for each child were video-ed. This served as additional material for analysis and feedback sessions with the Developmental Psychologist, Specialist SLT and Specialist Outreach Teacher, and also as a record and guide for the parents on taking on the role of play-partner.

Review took place for each child at the middle and end of the process. These tended to involve the same parties as the initial meeting, but could include, for instance, the child’s own speech and language therapist or nursery teacher.

Weeks 15 and 16 were termed ‘handover’ sessions, in which the adult (usually the Mother, but it could be any family member; member of nursery staff or involved adult) who would be taking over from the advisor as ‘play –partner’ was included in the session. Prior to this the advisor would provide them with materials to produce a box similar to that of their child and the advisor. Opportunities to discuss the upcoming session and the types of play intended were also provided. While parents were advised that it would not be possible to provide ongoing verbal feedback during the handover session, due to the need to retain the shared play focus, discussion could take place following the session. The aim of these handover sessions was to incorporate the parent into the session, as a gradual transaction and learning process, rather than as direct instruction. These sessions were not subject to the same analysis process as the previous sessions due to the qualitative difference of the interactions (now a three-way interaction, or more if dolls or teddies were also involved as extra participants!)

Final reviews took place following the handover sessions. These focused on any developments noted during the course of the project, both within the play sessions and any generalization to other settings. The autism advisers input and observations were discussed, together with observations from the parents and information from within the nursery or school setting from the Specialist SLT and Specialist Teacher. The review also offered parents the chance to raise any queries over their new role in the joint-play process, and discussion of possible extension of the approach to siblings, other family members or settings.   The multi-agency approach was valuable in that it provided a forum in which parents could raise queries and receive information on areas such as transition to, or issues within, nursery or school; specialized input required for their child; support around specific issues including toileting and behaviour problems such as biting.

The review meeting was supplemented by a presentation pack for the parents. This contained a detailed written report, including recommendations for the parents, written by the autism advisor in consultation with the developmental psychologist; a copy of the 3 sessions video-ed and photographic stills of particularly positive interactions from the videos.

Session Content

The initial session for each child involved a range of play materials and activities in line with the SHARE categories. Information provided by the parents enabled activities to be pitched to the child’s level and interests. Typical activities included those focusing on ‘expressive and attentive play’, joint goal directed play and, perhaps, joint imaginative play, which might lead into ‘joint imaginative play with an additional representational animated participant’, for instance, teddy, doll or Thomas the Tank Engine! Duration of this and subsequent sessions varied, with some children initially tolerating only minutes while others remained involved for up to 40 minutes.

Each session began with a predictable routine, frequently pre-empted by visual (i.e. a photograph of the advisor) or verbal information from the parent so that the child would quickly come to anticipate the arrival of the advisor greeting them with smiles, eye contact, and advisors photo in hand! The overall structure to the sessions included bringing the boxes inside a bag, and a predictable routine for unpacking and repacking the boxes was established. Where the child required further support to understand and anticipate in the session this was provided, for instance, through a visual schedule; a card showing a red circle and a green circle with a movable dial in the middle to encourage understanding of start and finish (red for stop play; green for go play) and a pictorial schedule of the advisor and the boxes which was shown prior to the session then posted into a box at the end to indicate finish.

Play Structure

The advisor would fill the box with toys pertinent to each category of the play structure, for example:

Joint expressive/attentive play:

Bubbles, balls of different textures, party blowers, beads (the same or similar toys in each box)

Joint Goal-directed play:

Train set – linking parts, such as train track, in one box, with main engine and carriages in the other.

Table-top games, with, e.g., boards in child’s box, and dice and objects in the   adult’s.

Imaginative play:

Items like sunglasses, play food, shop items, cash register, doctor’s set, tool set’

Toys to encourage understanding of ‘representational other’ like teddies, lion puppets, small figures animals, with some in each of the boxes.

The advisor would use various techniques in the delivery to encourage engagement in all of these categories. In joint expressive play the advisor would encourage the child to look at, touch, explore items, and this could lead into other categories, for example, bubble play could start off with blowing the bubbles towards the child, then the child would pop the bubbles and perhaps teddy would pop them too, therefore moving through all the categories. Joint goal-directed play could be simply rolling the ball, playing peek-a-boo, or simple turn-taking games like building a tower, to more complex board games using a dice, which again could develop to include teddy. Joint-imaginative Play could consist of either the advisor or the child initiating, e.g. shop, simple pretend and symbolic play where the child would use the cup to drink pretend tea or use an object to symbolize another; for example, if there was no car left for the advisor, she might demonstrate the use of a brick to represent a car in play. This could develop to more complex role play with both the child and the advisor acting out characters in a storybook by taking on the role of a postman or doctor or nurse and suchlike.

Imaginary play could involve teddy or doll, encouraging understanding of affect by projecting feelings to the teddy or doll. By seeing these concrete role models some children were then able to show an understanding by imitating from memory recall of the sessions. This was evident with some of the children imitating the advisor’s scenarios with puppets or doll exactly as she had shown it. From this more complex and creative imaginative play could develop.

As well as revealing strengths of the child, the assessment system indicated areas upon   which activities could be focused for development . For example one child may need to have a focus on developing more complex goal directed play, where another child might need expressive play as a focus to encourage more tolerance of touch or noise.

One parent reported her child initiating play from the sessions such as dressing dolly and playing ring games with her sisters. Another reported her child saying words she had never heard her say before   (naming items from the toy box, such as   ‘train’ and ‘monkey’ ). Another parent reported her child initiating play with her for the first time with a tickling game.

Many parents reported sounds of laughter from their children, which had been missing from their play, and how the children looked forward to the advisor’s visit.

A full report of the results of the delivery of all the sessions was given to the parents and other professionals involved. All reports demonstrated some degree of progress for all children.

Additional input within play sessions

The SHARE play sessions also provided a positive setting for assisting certain children in areas not targeted by the JPIAM. For example, one child who had some difficulty with fine motor skills, resulting in lack of confidence in writing, drawing and manipulating small objects, was encouraged to participate in activities such as making ‘play-doh’ models; cutting ‘velcro-ed’ together plastic food and using chunky crayons and chalks, on the advice of the developmental psychologist. The positive environment of the play sessions appeared to encourage his attempts at these activities and he showed increasing confidence, eventually initiating using fine pens to confidently help draw and write out visual supports for games. Another child whose developing toilet skills were being focused on in the home setting had this linked to use of a dolly with a potty during the play sessions where his toileting routine was emulated by dolly, helping to reinforce and generalize his known structure. A third child was helped to overcome a difficulty with textures by encouraging him to focus on a weighing game using balls of different weights and textures. By focusing on the weighing and charting the results, the child was engaged with the advisor on producing a chart displaying the heaviest and lightest ball, and was able to tolerate the textures to complete the task.

Emotional and practical support to parents

An advisor was also at hand to deal with emotional upset, which was evident in some parents where diagnosis was overwhelming in emotional terms. Some children were upset initially and this had a similar impact on some parents who found it difficult to see their child upset. However, support and encouragement along with reinforcement of the child’s ability to switch mood to enjoyment, saw parents themselves change to more confident and enthusiastic supporters to their child. Many gave wonderful ideas for strategies in areas within the home, making play more holistic for the child.

Results and Evaluation

Using a multiple baseline design, developments in occurrence and extent in category and sub-category areas were analysed for the participant group. Table 1 presents an overview of gains shown by the children by the end of the intervention period, collapsing the category analysis into overarching category areas. All the children showed developments in engagement, communication and shared interpersonal understanding. Most children showed progression in involvement in imaginative joint play, with over three quarters of the participants becoming involved in imaginative joint play with symbolic representational others.

Table 1: category area and % of children showing gains

Engagement and type of play

100%

Sharing feelings and ideas

100%

Communication and perspective taking

100%

Imaginative joint-play

95%

Imaginative joint-play with symbolic representational others

78%

Further results came from the review meeting with parents and professionals and independent evaluation was carried out by the educational psychologist through interviews with the parents. Parental feedback was very positive and all professionals involved feel the SHARE innovation has been a great success for multi-professional working and sharing expertise – and indeed it won a COSLA Silver Award in 2004 and was written up in the Times Educational Supplement Scotland (TESS) in July 2004.

Perhaps the most informative evaluation comes from examples of words spoken by parents and local SLTs involved:

Parents (from review meetings)

Local SLT and Nurseries (from review meetings)

References

Beyer, J. and Gammeltoft, L. (1998) Autism and Play. London: Jessica Kingsley

Dewart, H. & Summers, S. (1995). The pragmatics profile of everyday communication skills in children. Windsor: NFER.

Emde, R., Kubicek, L. and Oppenheim, D. (1997) Imaginative reality observed during early language development. Int J Psychoanal, 78 (1): 115-33  

Janert, S. (2000) Reaching the young autistic child: reclaiming non-autistic potential through communicative strategies and games . London: Free association Books

Jordan, R (2003) ‘Social play and autistic spectrum disorders’. Autism 7 (4): 347-360 .

Libby, S., Powell, S., Messer, D. and Jordan, R. (1998) Spontaneous Play in Children with Autism: A Reappraisal. Journal of Autism and Developmental Disorders,28: 487-97.

Marwick, H.   (2001) The Joint-Play Intersubjectivity Assessment Method (JPIAM): use with Autistic Spectrum Disorder children and their interactive partners. University of Strathclyde, Glasgow.

Marwick, H. and Mackay, G.F. (2004)Imaginative representation in joint-imaginative play in pre-school children with autism. Australian Association of Special Education International Conference. Hobart, Australia.

Sherrat, D. (2002)   Developing Pretend Play in Children with Autism: A Case Study, Autism, 6 (2): 169-79

Stern, D. N.   (1985/2000)   The Interpersonal World of the Infant: A View from Psychoanalysis and Development Psychology.   (Second Edition, with new Introduction)

Sussman, F. (1999). More Than Words: Helping Parents Promote Communication and Social Skills in Children with Autistic Spectrum Disorders. Oxford: Winslow Press.

Tamis-LeMonda C. S., Chen, L. A. and Bornstein M. H.(1998) Mothers' knowledge about children's play and language development: short-term stability and interrelations. Dev Psychol.   34(1): 115-24.

Trevarthen, C. (2001) Intrinsic Motives for Companionship in Understanding: Their Origin, Development and Significance for Infant Mental Health. Infant Mental health Journal, 22 (1-2): 95-131.

Trevarthen, C., and Marwick H. (1986) Signs of motivation for speech in infants, and the nature of a mother's support for development of language.   In: B. Lindblom and R. Zetterstrom (Eds.)   Precursors of Early Speech. (pp. 279-308).   Basingstoke: Macmillan.

Trevarthen, C., Aitken, K. J., Papoudi, D., & Robarts, J. Z.   (1998).   Children with Autism: Diagnosis and Interventions to Meet their Needs.   (Second Edition)   London: Jessica Kingsley.  

World Health Organisation (1992) The IDC-10 Classification of Mental and Behavioural Disorders: Clinical Description and Diagnostic Guidelines. Geneva: WHO.

Zercher, C., Hunt, P., Schuler, A. and Webster, J. (2001) Increasing Joint Attention, Play and Language through Peer Supported Play.   Autism, 5 (4): 374-98

The SHARE team

University of Strathclyde:

Dr. Helen Marwick, Co-Director, National Centre for Autism Studies

Professor Gilbert Mackay (Professor of Special Education)

South Lanarkshire Education Authority:

Adrienne Shaw (Specialist SLT)

Lisa Glashan (Pre-5 Outreach Teacher)

Scottish Society for Autism:

Autism Advisers: Jackie Cramb, Mary Hamilton, Jeannie Hardie, Elaine Leghorn, Anna Robinson, Caroline Schofield.

Acknowledgements

We would like to thank all the children and families who participated in this programme, and other professionals who accommodated the programme within their work setting.

 


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