© David Sponder, L.E.P., BCBA, Floortime Intermediate C3c
Executive Director, Sponderworks Children’s Services

Non-verbal Performance Revisited

The most important features of nonverbal performance can be thought of in this order:

  1. The brain must be able to focus attention on something in order to organize/manage perception and responses to perception
  2. In dynamical systems or environments, the brain must notice change. The brain can only recognize change if it can tell the difference between what stays the same and what changes.
  3. The vast majority of the changes that occur around us are not verbal – even if the mental task we are engaged in is conversation. Noticing relevant changes in the environment yields a sense of control and understanding if we can make sense of it. People notice movement, the appearance or disappearance of things, sounds. When we engage in tasks or focused activities like conversations, our brains “prime” us to notice certain things over others. This process of priming or mental anticipation also sets us up for noticing irregularities. Importantly, changes occur in the environment all the time, and they do not necessarily announce themselves as overtly as prompts, nor do they respond well to rehearsed or scripted [static] responses. A reliance upon “discovery” methods, where Guides learn to enhance things or arrange things in ways that make natural “noticing” more likely (e.g., amplifying the inflection, exaggerating facial or body gestures to the point of being “noticeable” and “readable”).
    This is a critical paradigmatic difference between teaching responses didactically and relying on prompting and fading approaches to promote generalization.
  4. Changes involve constant shifts of attention.  With each shift – the thousands of processors must reorganize quickly to yield a new perceptual whole.  They must form a brand new, emergent (Grigsby & Stevens, 2000) system that is coherent and yields a reliable and continuously updated representation of the world in the mind.
  5. To keep track of the current position or meaning of the system (the conversation, the event), the brain must choose a frame of reference points to place in its current window of conscious awareness. Because dynamical systems involve multiple layers of information (context) that shift constantly – attention must shift along with it and the brain must be able to move information across its multiple recurrent pathways quickly and efficiently.  If it can’t it gets overwhelmed and shuts out too much information (called ‘overselection’) and/or hyperfocuses.

What did you say?  Hyperfocus?  Shutting out information?  That sounds like autism to me.

Non-verbal Performance, for the purpose of this article and the body of techniques outlined at the end of it has very much to do with teaching individuals with ASD how to manage their attention so they can survive (and stop avoiding) – change.  Steven Gutstein defines a core deficit of autism asdifficulty managing uncertainty.” In any system, whether it involves a system of one person behaving, acting on an object or several objects, or a person interacting with another person or persons, etc., there will inevitably be change.  Degrees of change go from very little (static systems) to systems that are characterized by change (dynamical systems), to systems where too much change leads to incoherent instability (chaotic systems).  As an interventionist, it is useful to recognize patterns of behavior as systems that fall somewhere along that continuum.

Arnold Miller, an Occupational Therapist by discipline, was among the first to look at autism in terms of Systems Theory. He identifies several types of systems:

  • Body Systems: these have to do with how the mind coordinates its sensory perceptual and motor output systems together in order to organize behaviors. Organizing behaviors is a matter of operating in a functional manner to accomplish goals such as throwing a ball, getting around an obstacle, climbing a ladder, retrieving an object, etc.
  • Social Systems: These describe different but typical forms of “social coordination” between people.  For instance, they can take turns, imitate each other, operate in parallel (simultaneous mutual imitation), compete, form an assembly line, perform complementary actions (throw and catch), etc.
  • Communication Systems: these involve combining the multiple devices of non-verbal and verbal communication to convey meaning between people or between people and machines, and
  • Symbolic Systems: how we use representations of reality, such as how sounds are represented by letters, words represent objects, events, concepts, etc., pictures and gestures represent ideas, and (my interpretation) how series of actions imply or represent intentions.

Miller identifies individuals on the autism spectrum as falling into two major groups: those that have difficulty forming systems and those that form rigid systems. Their systems differ according to how ordered they are (level of organization, integration and complexity), how flexible or rigid they are, and their “distance from reality” (how much a person can represent reality with symbols).  He defines autism pretty much as “System Forming” and “Closed System” disorders, borrowing heavily from von Bertalanffy’s General Systems Theory.  Here is a table [heavily adapted] from his 2007 book (I’ve added a bit): (Fig. )

Arnold Miller’s taxonomy underscores the problems with managing attention, focus, and the organization of responses – all nonverbal foundations of communication and social behavior.  They all have difficulty finding reference points that allow then to notice and respond to change in flexible and coherent ways.

Fig.

Disorder

Type of Individual on the Spectrum

Closed System (often described as “high functioning”)

Type A

Type B

Poor executive function as characterized by restricting the number and variety of systems; rigid, inflexible Less restrictive.  They can function with many object systems
Poor attention shifting and scanning of the environment; They can shift from one system to another, but they often focus on irrelevant or idiosyncratic reference points
People excluded from their systems People excluded from their systems
System Forming (often described as “low functioning”) Poor executive function as characterized by basic problems with sensory-motor function; Integration problems evident in very overt “disconnects” (looking away as their hands interact with the object – a sign of one system “confusing another”)
Actions focused on their own bodies rather than on objects; interaction with objects severely restricted and repetitive (e.g. flipping a Lego; hand-flapping; pacing) Stimulus driven – shifting from one object to another without real engagement with any of them; interested in parts of objects – no understanding of the object’s real function

How do we learn what reference points are important and which ones are not?

Somehow, when we start or enter an ongoing system (object system: playing with blocks, trains, dolls, videogames, operating computers or machinery; turning on a lamp, etc.; social system: the conversation in the lunchroom for instance; entering a new classroom or retail store or movie theater; joining a group at a party, etc.) – we have to scan for reference points that give us an idea of what to do at the moment.  How do we learn how to do this?  Is it innate or hard-wired?

Almost all of it is learned. Jean Piaget, the Child Development Psychologist (that started as a biologist before there was a field of child development), studied how children explored objects.  He was interested in how children learn the physical properties of objects and the environment.  He identified stages of the evolution of exploration that are fairly universal, indicating a good deal of genetic wiring, but also the ways in which the environment shapes exploration behaviors.  Lev Vygotsky on the other hand, emphasized how skilled individuals guide or “transfer knowledge” to less skilled ones in a process he called “Guided Participation.”  B.F. Skinner emphasized how the effects of the consequences of one’s actions led to increases in behavior (expansion; “reinforcement” or strengthening of responses) or decreases (constriction; “punishment” or weakening of responses).  Researchers in the field of Infant Mental Health (Alan Sroufe; Ed Tronick; Daniel Stern) along with their intellectual cousins – systems theorists demonstrate how we learn from pattern identification (internal system formation) and variation in our exploration of people.  Basically, we learn from our experiences and observing how other people do it.  We observe what works and what happens to us, and what works and what happens to others and we form value systems for recognizing patterns and appraising the most important reference points of the systems we experience.  Here again, “experience (I cannot underemphasize the importance of this) is both personal and vicarious.  WE LEARN FAR MORE FROM VICARIOUS EXPERIENCES because they far outnumber personal ones.  This is why we want to shift away from teaching by prompting or other forms of imperative stimulation (see Appendix: Declarative and Imperative forms).  For more information on how different Theorists explain how the environment shapes how we learn reference points, refer to Appendix: Systems for Learning the Value of Reference Points.

Attention Shifting

We select and shift our attention for lots of reasons.  Generally, any pronounced change going on around us (e.g. a glass breaks; someone walks by) will draw our attention at least momentarily.  Also, our emotions not only predispose actions, they predispose where we’ll focus our attention. We tend to pay attention to things that interest us or that concern us.  The more emotionally young one is, the more attention is a slave to interest and concern.  People with autism, by definition, are emotionally younger than their chronological ages, so they tend to pay attention like younger individuals.  They have great difficulty attending to thing that other people want them to.

As I pointed out earlier, on a Neurological level, executive machinery such as the Anterior Cingulate Cortex and Prefrontal Cortices take up perceptual and emotional input (the appraisal of sensory information) from attention and coordinate behavioral responses in a continuous cycle.  Movement creates changes in perception → perception activates attention → attention is movement that searches for perception (it is a motor response: our eyes shift and so do our ear drums – like little radar dishes) → perception is stored temporarily as working memory as attention shifts to something else (attention and memory are forms of the same thing) and so forth and so on.

  • Attention selection is largely the function of two key classes of emotion: those that are based on interest, opportunity (predisposing approach behaviors), and those that are based on fear or perceived threat to survival (predisposing flight, freeze or fight behaviors). So any information entering the mind that signals threat or opportunity strongly enough will evoke responses.  There is room for a great deal of difference in this threshold as opportunities and threats involve appraisal, and emotions heavily bias appraisal.  But information that signals intensive opportunity or threat tend to jump the line among competing stimuli for attention;
  • In less intense situations – or the vast majority of the time, we learn a value system of attention by following other people’s attention over the course of our lifetimes.  The focus of others’ attention continues to be a current force in our attention or stimulus selection – so it is essentially a social learning process. Choosing the most salient stimulus to pay attention to is an emotional process as well.  Our affiliation with others and corresponding identification with others’ interests, influences our choices of attention by social means.
    • Most of the choices of where we place our attention occur in situations in which we are bystanders or eavesdroppers on others’ attention and where and what they focus it upon.  The people we reference in this way may not be aware that we are doing this.  This happens very frequently, so it is fair to say that much of what we’ve learned about what to pay attention to involved an indirect process.  One does not need to be directly involved in interaction to learn this, if one has developed the dynamic thinking ability or tool of referencing others’ attention.

Attention, Theory of Mind, Intention-Reading, Anticipation and Fear v. Competence in Managing Uncertainty

Behavioral Melodies and Behavior Gestalts

The Educational Psychologist Mel Levine described sequences of related steps and actions as Behavioral Melodies.  I call them “Behavioral Gestalts” – where the whole is somehow greater than the sum of its parts.

The “Get a Drink” song

Note 1 Approach the refrigerator Note 9 Open the cabinet
Note 2 Open the refrigerator Note 10 Scan the cabinet
Note 3 Scan the contents of the fridge Note 11 Retrieve a juice glass
Note 4 Locate the juice container Note 12 Bring the glass over to the container
Note 5 Retrieve the container Note 13 Position the glass and container
Note 6 Close the fridge Note 14 Pour
Note 7 Put the container on the counter Note 15 Lift glass
Note 8 Approach the cabinet Note 16 Drink

You’ve done this.  I’ve done this.  Before we could do this, someone else did this for us.

Some of you might recognize the above as a “task analysis.”  That’s good, but keep that to yourself because thinking that way and talking that way makes you sound weird.  It also leads to the wrong kids of teaching in my opinion.  We don’t want to pixilate behaviors into parts because that is what people with autism do.  They see parts, but don’t string them together into meaningful wholes.

Instead, the person with autism either hyperfocuses on something else or some irrelevant part of the sequence, or looks away a lot and doesn’t glue the actions together into a “melody” or gestalt.  The notes may look like random actions, and the child may become agitated when the request isn’t immediately followed by juice magically appearing.  The child keeps requesting (crying, vocalizing or asking) until the juice hits the table in front of him (see Fig. ).

Infants begin to track their Caregiver’s behavior as early as three months, about the same time the begin to be able to prop themselves up on their elbows, which frees their head and neck to locate and follow the Caregiver’s movements across the room.  Sustained attention to the Caregiver’s sequences of actions is called “monitoring. Tracking and Monitoring go together. As infants do more monitoring, they feel less and less of a need to keep tracking.  An older infant, after indicating thirst, could’ve tracked and monitored through Notes 1 and 2 and be able to name the tune “Mom’s getting the Drink.” The infant can then relax and go back to what he was doing. The infant would probably experience no further distress unless there was some change in the pattern – say, the phone rang and Mom answered it, and she subsequently interrupted the sequence.

From this simple example of tracking and monitoring, we can see that an infant less than a year old now has a pretty large “song book” of behavioral melodies.  The largest chapter of the songbook has to do with simply dyadic patterns between the infant and an adult.  This knowledge of behavioral melodies or patterns allows the child to infer the intentions of others when they begin sequences that are familiar. Mother approaching the refrigerator functioned as a signal to the child that Mother intends to get him a drink because by now, that sequence is familiar – it is “an episodic memory.” In other words, the first notes of the melody bring up mental representations of similar episodes or “songs,” and a corresponding set of anticipations and expectations.

Fig.  To understand how the mind of a person with autism works, let’s first stipulate that the whole thing is initiated by thirst.  So here’s the Autistic “Fractured Get a Drink Song”

  Event Event Explanation
Note 1 Requests drink (cries; asks) Mom says “OK, I’ll get you some juice” She has to add, “I’ll get you some juice” because Jr. does not always get the connection between his behavior and Mom’s actions.  He fails to see the connection between his behavior (cause) and her actions.  He does not recognize that she has to execute a series of steps to produce the juice in the glass.
Note 2 Mom approaches the refrigerator Jr. keeps requesting.  “I’m getting the juice honey” This reassurance produces no change in Jr.’s requesting.  He gets increasingly agitated. Instead of watching her, he’s watching the spot on the table where the juice usually ends up.
Notes 3 -14 Mom performs the steps of the sequence Jr. looks at the spot.  He looks up, down, away, at his own hands flapping.  He looks everywhere but at the reference points that would reassure him that juice is on its way. He does not recognize the sequence because he does not track or sustain his attention to a series of related actions.  He is not monitoring the progress in order to anticipate when the juice will arrive so he remains agitated until…
Note 15 Mom places the glass in front of Jr. Jr. finally stops complaining. Jr. complained the whole time because he could not “name that tune” as early as Note 1 or 2.  None of the succeeding steps of “notes” provided any sense of anticipation or prediction, so anxiety prevailed.  Notes 1 or 2 should’ve been enough to help him manage his uncertainty about when his thirst would be quenched.

Long before the infant notices patterns of actions on objects, the simple contingent responses between parent and infant (the dyad), the baby’s random and almost accidental actions produce responses on the parent’s face that reflect how the child must feel.  Parents shape unintentional responses into intentional ones over time, through this contingent responding. The baby moves, Mother smiles.  The baby grimaces from a gas bubble, Mommy goes “Awww” and frowns.  This is called, “mirroring.”  This process creates simple patterns and the baby’s growing understanding that his actions cause other things to happen.  In the early months, most of this is face to face in a very intimate dyad of ongoing contingent responding.

To benefit from this, the baby must have enough biological integrity – or capacity to form coherent perceptions and to control responding – to take in sensory information properly and organize responses intentionally. Difficulties with sensory-motor integration at this stage can cause this process to go awry and lead to cascading social, emotional and behavioral deficits.

These little but very important social episodes form the foundations of all other forms of thinking later on – especially those that involve pattern recognition. Pattern recognition of any kind starts with social pattern recognition, because the baby can’t really manipulate objects so early on.  Pattern recognition begins to involve finding reference points such as other people’s gaze direction, the sound of their voices; the speed and direction of their actions – all of these lead to “meaning making,” or the appraisal of the value and directionality of patterns.  Mastery of this involves being able to assemble the pieces together into wholes. The wholes become stored as episodes instead of individual steps or actions.  The parts lead to recognition of the rest of the pattern – which is the cognitive foundation of intention-reading and anticipation.

Characteristic Deficits in Episodic Memory

Deficits in “Episodic Memory” in individuals with Autism are well-documented (Lind, S. E., & Bowler, D. M. 2009).  Episodic memory is one of the most important internal reference points that we learn because you cannot recall and you cannot use information that you did not notice and did not commit to memory.

As we’ve pointed out throughout this article, if a person experiences problems with the initial encoding of what happens around them, does not notice things and does not associate them with other meaningful events (this is the job of the emotional brain), and/or the emotional brain does not recognize the relevance of an event and does not commit the information to memory.

A big part of the problem is the failure to notice that actions are connected. When the mind perceives a behavioral gestalt, it usually remembers the gestalt (e.g., “making a milkshake”), rather than the steps. But even though we might not remember all of the steps or perform them accurately, we can still refer to the gestalt as a whole. This makes it easier to remember as a mental index tag for the rest of the information.

If on the other hand, your attention to events is spotty (actually called “spotting” when describing errors in environmental tracking and monitoring), you miss important events that connect individual actions and events into a meaningful intention or cause. Properly primed, the brain will notice and record events that are relevant to the emotional window frames in which each partner experiences them.

If one encodes information by spotting rather than tracking in real time, one is bound to have only a sketchy and unelaborated, poorly understood memory of the episode. Events may seem random rather than connected, logical – expected or anticipated. We can only make sense of episodes when we’ve done the work of paying attention to them mindfully – by tracking and monitoring until we reach a state of understanding – or a “gestalt.”

Think of what it must be like without the ability to organize events in the environment into meaningful patterns. Life can be experienced as random. There’s no way to predict what happens. People’s signals don’t tell you what to expect.  Everything can startle you.  It takes you a long time to recognize patterns, and when you do – you don’t want them to change.  You become inflexible.  You prefer static systems to dynamic ones.  Other people’s behavioral patterns don’t make sense to you, so you focus increasingly on your own actions.  When you see patterns that are too complex, you withdraw or avoid rather than approach and explore.  You become increasingly delayed – autistic.