TTTV060: Unpacking Autism with Clinical Psychologist Lydia Meem

Tim: Lydia, welcome to the show today.

Lydia: Thank you.

Tim: It's so great. We're laughing because we've had so much trouble getting you on the call today. This is about our third attempt, it feels like. I'm really, really glad that you've been able to persevere and come on the show today because you've got a really interesting perspective, I think, for us.

And just before we begin, I'm really interested to know, you're a clinical psychologist.

Lydia: Yes.

Tim: What does that mean? How's that different to a psychologist?

Lydia: Okay. So a clinical psychologist has done more training. So we do standard four years and then we do another two...well, often more years to do a master's as well, so it's very practical.

Tim: Okay. And then psychiatry, that's another whole thing, right? Or does that normally deal gone from there.

Lydia: Oh, yeah, that's completely different.

Tim: Oh, it's different.

Lydia: Psychiatrists are doctors, so they do medicine first and then they do psychiatry, whereas psychologists, we do psychology, so we're behavior people, not doctors.

Tim: Okay, cool. All right.

Lydia: Unless you do a PhD, and then you're a doctor, but you're not a medical doctor.

Tim: Yes, got it. All right. So look, can give us some background about your experience? And maybe a little bit about what your day looks like normally, what kind of things you're doing with students.

Lydia: So I have a private practice in Newcastle, and I see children, mainly, and then adolescents and adults, and sometimes couples on the autism spectrum. So I specialize in autism and developmental disorders, and I do lots of behavior support stuff, so managing challenging behaviors. And I do diagnosis as well, so I look at autism assessments, cognitive assessments so IQ, developmental assessments, reading assessments, adaptive assessments, which is like everyday living skills, and ADHD and ODD, so hyperactivity and passivity, inattention and behavior difficulties.

Tim: You said ODD, did you mean OCD or have I got that wrong?

Lydia: No, no. ODD is oppositional defiant disorder. So you might have come across some quite stroppy kids. Yeah. So they're the "you're not the boss of me" kind of kids.

Tim: And that's a behavioral thing. So this is a mix of behavioral issues and also actual diagnosis of disorders, right?

Lydia: Yeah. So when the behavioral stuff gets really out of control, then kids might make...you might make a diagnosis of oppositional defiant disorder or conduct disorder.

Tim: Right. Okay. Yeah, got it.

Lydia: Yeah. So that's an additional diagnosis. So, some of the kids that I see have four or five labels when they come to see me. So they might have anxiety and autism and ADHD and a bit of ODD. And sometimes they might have some OCDs, so obsessive compulsive disorder. They tend to come to me when there's lots going on. Yeah.

Tim: And I think it's great to talk with you because you're the person who is actually doing the diagnosis. And as a teacher, I've been in a situation where I've had a student with me and I haven't had any discussion. The parent haven't come to me and said, "Yes, so and so is ASD," and you have to sort of think, "I'm pretty sure there's something going on here." And you're the person that's actually saying, "Yes, there is something going on here." So it's great to go and actually get the information that we need right from the people who are doing the diagnosis. So thank you very much, again, for coming on.

Lydia: Oh, no worries. And I guess, for me, I'm often talking to parents about that it is okay to tell people like piano teachers that their child has autism, and often parents are afraid to do that because they think that you're gonna not want them as clients or that you're gonna somehow treat them differently. And so I say to them, it's really important that they let you know, so that then you can use the strategy so that they can have a really good time when they come and learn to play the piano. But it's not about escalating them.

Tim: I mean that connection that we have, we're very lucky, one-on-one for potentially years of a student's life. You know, I'm glad you're saying that to the parents because we need to know. We can't do our work without knowing. Yeah.

Lydia: No, no, you definitely need to know. Yeah. And there's definitely things you can do to make it easier. Yeah.

Tim: Yeah. And so we'll talk about some of those things in a moment. But I'm interested, you know, this month the focus in the podcast has been on special needs teaching, which is kind of general thing that encompasses a whole lot of areas. But it's been interesting. Most of the people I've spoken to have a real focus and experience with autism. And your business is all about autism, why is it that autism has so much focus at the moment?

Lydia: Well, I think it's getting its time in the sun at the moment. So you might remember...oh, I don't know. About quite a while ago now, there was a stage where ADHD was in the spotlight and kids were getting diagnosed with ADHD all the time, and now, I think it's shifted and people are becoming much more aware of autism and it's in the media all the time. So that has good things and bad things. Yeah, not everyone who has been diagnosed with autism makes the diagnosis, so we need to do the autism assessment properly. Some people with autism have only seen a pediatrician for 10 minutes and then they've made a diagnosis. That's not the best way to diagnose autism.

Tim: Yeah. I can imagine.

Lydia: When I do it, it takes 10 hours, at least, including report writing time. Yeah. So you need to go through a whole process.

Tim: People can get that diagnosis just from their...You said pediatrician, so a doctor.

Lydia: Yeah. So not usually their GPs. GPs are smart enough to refer on. They're just good.

Tim: But they'll refer to a psychologist or a pediatrician.

Lydia: Yeah, usually. It varies depending on the state. So different states have different...Like example, the school system in Western Australia, they want you to be seen by a pediatrician and the psychologist, and the speech therapist to make their combined diagnosis, whereas in New South Wales where I am, I can make the diagnosis on my own. But then if they want funding through a certain funding body, then I have to get a speech therapist to sign off, whereas they'll accept a one-line letter from a pediatrician or a child psychiatrist saying, "This child has autism." They won't accept my 16-pages report without a speech therapist saying, "Yes, I agree." So it just depends on the situation.

Tim: People living in America, it's like they'd be different again, potentially.

Lydia: Yeah. So there's gold standard assessment tools that we need to be using, but not everyone uses them. Yeah. So there's been a push lately for us to get more standardized about how we assess for autism, and that would be a really good thing.

Tim: I was gonna say that could only be a good thing, I would have thought.

Lydia: Yeah, that would be a great thing. Yeah. And I think it's really important that we do it properly too because there's a whole lot of grieving that goes on when parents are going through this process of getting their child assessed. And if we do it properly, then they can actually be part of that process and see why we're making the diagnosis. And often they have gotten used to their child's behaviors, and so they might not see what I'm seeing.

And so, I'm often explaining to parents, "This is what I'm seeing. You know, they're playing in the corner of the room. Have you noticed we're seeing a lot of the back of their head today? They're not looking at us. You know, they really like their toy but they haven't shown it to us. They're not trying to get us to have a turn." That kind of stuff. And so that's, you know, explaining why I'm making the diagnosis so that then it's not such a shock when I'm telling them.

Tim: And I imagine, for some parents, they might not know that something is unusual if that's their first child.

Lydia: Absolutely. Absolutely. Yeah. So often, it's not until their younger child overtakes an older child that you get people going looking, or if their child is not talking. So often there are actually signs like when the baby is 12 months old, but parents don't know how to look for those things. Yeah. So often it's not until they're not talking. And if you have someone who is higher functioning, who has more language, then often that will get picked up until they're in primary school. Yeah.

Tim: So I wanna just talk a little bit more about this idea of assessments because you've really kindly actually given us a two-page assessment sheet.

Lydia: Yeah, it's just a screening tool.

Tim: Now, you better explain this because we obviously don't wanna think that we're assessing and diagnosing autism on a two-page sheet. How would you see teachers being able to use this sheet?

Lydia: Okay. So what it is, it's an ASD Student Profile, and it's really an information gathering tool. So I use it as part of my assessments because I send it to school along with another Asperger's questionnaire and get their teachers to fill it in for me. When I'm doing the diagnosing, I use two, the gold standard assessments. So one of them is the Autism Diagnostic Observation Schedule, which is a play-based assessment that takes a good hour. And then there's also another developmental interview called the Autism Diagnostic Interview, Revised, and that takes about two and a half to three hours with the parents to go through all their developmental history and look for all the behaviors. So that's what I would call a diagnostic assessment. So the ASD Student Profile is not any of that. It's just an information sharing tool.

So the thing about a lot of the screening tools, so the other one that I use, the Australian Scale for Asperger's Syndrome, which you can find on the Internet. That's put out by Tony Attwood, who's well-known in autism. Those questionnaires will often have a behavior and then, you know, you have to say yes or no or you might have a scale from naught to five or something like that. And so if you're getting lots of fives and fours, then that tells you maybe it's time for an autism assessment, but it doesn't actually tell you the specific behaviors the child has. It just kind of says how they fit into these various boxes. So the ASD Student Profile is something I came up with to share the specific information.

So my first thinking about it was for casual teachers coming into school. Like if the kid’s teachers are away, the casual teacher can quickly read their sheet and see what they need to know about the kid in their class or the handover time from one year to the next, that kind of thing. But equally, it can be for you guys, it can be for scout ladies, basketball coaches, if they go on camp, you know, all that kind of stuff. So it's about knowing how kids communicate, what kind of social skills difficulties they might have, what the interests are so that you can get rapport with them really quickly, and then what kind of behaviors you need to be aware of, sensory sensitivity, teaching strategies, that kind of stuff. So it's really quick tick-a-box thing. But if you get the parents to fill it out, and if you have adolescents, they can actually fill it out themselves and give it to you, which is great.

Tim: I was gonna ask about that.

Lydia: Yeah. So that's why I've put it into "I" language. So it's talking about, you know, things, like it might be, "I sometimes have trouble knowing how to start a conversation" or something like that. So then they can tick that box themselves. So that can be really empowering for adolescents, particularly.

Tim: Yeah. And as soon as I was reading this sheet and everyone listening or watching can download this topmusic.co/episode60. We've got the sheet there ready to download. And I thought, yeah, this is perfect for a parent that rings up and would like a first trial lesson. And says, "Look, my student here is on the autism spectrum," and one of us could just go, "Oh look, I've got this little two-page assessment, would you mind filling it out and sending it back to me so that I've got a place to start?" I thought that was brilliant, so I really appreciate you sharing that.

Lydia: Oh great. No worries.

Tim: I think it's really of great help. Okay. So let's talk about some of these strategies. We've had a few other people on the podcast giving their view as piano teachers, but as a psychologist, what are some things that can help us in our music teaching when we're focusing on students with autism?

Lydia: Okay. So the first thing is that kids with autism are visual learners, and so I imagine people have been talking about using visuals when you're teaching them. So I can show you a couple of things. Obviously, you would have your own visuals for teaching the music side. But in terms of the behavior management stuff, you might want things like listening ears and hands still. So when you're trying to get kids to pay attention to what you're doing, then reminding them to listen with their ears and keep their hands still. Look at you and look at your teacher's hands, and keep their mouth quiet. Those would be the things that you want when you're trying to show them something.

Tim: These are cards. You have these as cards?

Lydia: Yeah. So I just made them this morning while I was getting ready for today. So I just drew them. But you could have them on a strip. Like often you might see ones where people have laminated them just so that they don't get wrecked. And you can put a bit of Velcro on the back of them so that then you can move them around and mix them up as much as you like.

Tim: And so for students sitting there and really fidgety with their hands, you're saying on...

Lydia: Yeah. You would tap their hands still, you know. Then you don't have to talk as much because a lot of kids with autism have trouble with auditory processing. So it would remind them to keep their hands still. And the other thing is then you're not harassing [sp] on them. So they're not arguing with you, they're arguing with a piece of paper. So it takes some of the angst out of it. And kids with autism aren't offended by this kind of stuff.

Tim: Great. That's a really great strategy. Yeah. That's something simple that anyone could try out right now for that thing. I really like that.

Lydia: Yeah. So this kind of idea, if you're more interested in that, there's a book called, Whole Body Listening Larry or you could get posters of Whole Body Listening Larry. So he listens with his whole body: so looking at the person who's talking, listening with their ears, keeping their mouth closed, their hands still, their feet still, thinking about what the person is saying and caring about what the person is saying. Yeah. So that's the full version, but I was thinking those ones might be popular.

Tim: Yeah, absolutely. And I should mention too, if you're watching this and you haven't had a look at Lydia's blog post from this week where I put together those comments that we had in our email conversation, I've actually put links to some of those things I went and found them online. So if you could, check out that blog post. Just go to topmusic.co/blog, and you'll find her post there.

Lydia: Cool. Yeah. So another one, often kids with autism, they don't understand about taking turns. Like this one I just drew it, but you can make it like if you grab a spinner from a board game, you can make it so that you've got a little arrow and you have the teacher's turn and the student's turn, so you can put your names on. And then, again, like, you know, when you wanna have a go at the piano and show them something, then it's your turn, and then when you want them to have a go then...

Tim: You flip the arrow across. But if you're listening to this, it's like the top half of a circle with a teacher on one side and the student on the other, and an arrow that you could flip between the two. So again, it's the visual way of saying who's doing what now.

Lydia: Who's turn it is. Yeah, that's right? Because, yeah, kids might get confused about that kind of thing. And I think part of the...if you understand where that comes from...Has anyone talked about theory of mind with autism?

Tim: I'm not sure they have, actually.

Lydia: Okay. So the theory of mind is the idea that everyone has their own thoughts and feelings, and knows different information. And so a lot of kids with autism struggle with that. So they assume that you know everything that they know, and often, you might find if you have students who have autism, they'll start telling you a story in the middle, and they'll forget to tell you where they were, when it was, what they were doing, that kind of thing. And they start going, "You know, blah, blah, blah." And you're like, "What are you talking about?" That's because they don't have theory of mind.

And so that's really important as a teacher because often as teachers, we expect kids to just do what we want to please us. And so the idea of being able to please the teacher, like, even if they wanted to, often kids with autism don't know how to do that, and they might not even understand why that would be important. Like that's one of the things that would make doing piano teaching a great intervention for kids with autism is the chance to practice all of their skills. So understanding that if they're gonna learn how to play the piano, it might be helpful to listen to the piano teacher occasionally, rather than just play on the piano.

Tim: Yeah. Got it. Well, I was gonna ask what you thought about the end goal, I guess, of working with autistic children and music. You know is it about that they can play at a concert, or is it about the other things they're learning and really the piano is just the side thing?

Lydia: Well, I guess both. So there are some really talented, musical kids with autism. There's quite a few people with autism who have perfect pitch, and so music opens up a whole world for them. And particularly, some of the kids that I see don't read very well, and so being able to read music gives them self-esteem and all sorts of stuff. You know, music makes sense for them in a way that reading doesn't. Yeah, so there's that kind of stuff, but it's also the social side of things, too. Yeah, definitely.

Tim: Yeah, just trying to build those skills. Conversation and taking turns as you said. What we take as very simple things that they can't get so well in a classroom environment necessarily. So one-on-one, we're in a lucky position to have a really big impact, right?

Lydia: Yeah. And so that's part of what I do when I'm working with kids is I'll be working on their skills so that then hopefully they can generalize that to other settings like when they go to piano lessons or in the classroom, or in the playgrounds. Yeah.

Tim: Now, you mentioned a little bit in the blog post about eye contact. Can you tell us about eye contact?

Lydia: Yeah. So eye contact, we get a lot of information from looking at people's eyes. And so people with autism often are quite overwhelmed by all of the information that comes at them from people's eyes. And for some people with autism, it's almost painful to look at people's eyes.

Tim: Really? I never knew that.

Lydia: Yeah. Yeah.

Tim: I just assumed it was like an avoidance or...I didn't realize there was a point or a reason why.

Lydia: Yeah, yeah. It's information overload. And so, sometimes kids are actually startled if you try to make...Like I'm very often trying to make eye contact with them, so I'm watching them. You know, and I might be with them for an hour and finally get eye contact with them after 45 minutes. And sometimes they'll accidentally make eye contact and they kind of, you know, they're looking around and then they kind of go, "Ah!" And they're also like, "Ooh."And they'll look away, again.

So, yeah, and, you know, I've been sitting there smiling at them most of the time. But it is just too much for them. So there are some kids who you can teach to make eye contact, and it's not too evasive for them. And sometimes kids will learn that they're supposed to make eye contact so they kind of do it like this...You know, you have to teach them not to do that as well. That they can look away and then they look back at you. But it doesn't come naturally to them, so they have to learn how to do it.

Yeah, so we do that. But also, it's really important to know that often when we're teaching, we assume that if someone is looking at you then they're listening, but there are lots of kids who can't listen and look at you at the same time. So if you want them to listen to what you're saying, you actually need to let them look away.

Tim: And don't assume that they're not concentrating.

Lydia: Yeah. So often you might think, "Oh, this kid's not listening" because, you know, they're looking at the piano or they're looking off to the side, but then you ask them to do something and they just do it. So if that works for them, then that's okay. You don't need to insist on eye contact. But if you want to show them something like if you're trying to make a sound with your mouth, then you might say, "Look at my mouth," or, "Look at my hands." You know, to tell them where you need to look because they won't necessarily just because you're moving the hands, they might not know that's important.

Tim: Got it. I definitely found this one of the hardest things to change in my teaching when I've had Asperger's or ASD children, and that's just to realize because, I'm a classroom-trained teacher, and the first thing we do is, "Right, eyes up here." Everyone looking. It's ingrained in me.

Lydia: And then they might completely switch off.

Tim: Yes, exactly. They could be completely zombies in the classroom. They're looking to me, so I figure it's okay, right?

Lydia: Yeah. And sometimes all the effort that they're having to go through to look at you means they can't hear a thing that you say. So it's really important to ask parents about that, whether they can look and listen at the same time and what they would prefer. So if looking at their teacher is the goal for them, then the parent might want you to try and get eye contact with them. And so then what I would do is use toys to do that. Especially if you have a kid who hardly makes eye contact with you, there might not be a lot of playing the piano going on in the first sessions.

Tim: Or lots of sessions.

Lydia: Yeah. That often happens. Yeah. So often what I'll do is I have all these sensory toys on my coffee table, and I let them explore. And I tend to have two things or sometimes three things so that mom can have one as well, so things like this. I don't know if you can see. It's glowing.

Tim: So it's a fan, a hand-held fan.

Lydia: It's a fan, yeah. It's in the shape of a plane. It's a fan that lights up and it's got little foam blades, so you can put your fingers in it, and they will. And you can also like put it up in your hair and in the ears and up your nose, in your mouth. And kids with autism do that as well. So this is probably one of the most popular things.

So I have a couple of these on my coffee table, so if kids are playing with it, then I'll get one as well, and then they'll go, "Oh, you've got one too." And so then they'll be looking at my plane. And then I might have it up near my face and then they go, "Oh, there's person in there as well." So it's kind of getting them to shift. Yeah. So you follow their interests, and then try and connect with them based on both playing with the same thing.

Tim: Right. Where do you get that particular toy? Do you know where you got that, or what it's called?

Lydia: This one is actually really hard to find, unfortunately. I got it from Officeworks in the beginning, and then I've been able to get other ones but not the transport ones. Transport is a winner every time with kids with autism.

Tim: Either the back that looks like a plane.

Lydia: Oh, yes. Yes. So have some with planes and some with helicopters. Yeah. So I've got those from Walmart in America.

Tim: Right, okay. Well, we've got a big audience in America, so that's good to know.

Lydia: Well, if you go to Walmart, they're often at the checkout, so I bought like 10 of them when I happened to be in Hawaii. But in Australia, Big W has fans like these, but they all have Spiderman and Frozen and things on them.

Tim: Well, that's great to know. We might put some links in the show notes.

Lydia: Generally, anything that spins and lights up is good.

Tim: Great. That's a great tip. Thank you.

Lydia: Yeah. That's okay.

Tim: Did you wanna mention any other toys that you use that you can make a great connection?

Lydia: Sure, sure. Yes. Okay. So this one, allow me to pick it up the right way. I need to tip it up the right way and then you can see. So, this one is an oil-drip timer.

Tim: Okay. So kind of like a lava lamp but oil's dripping down through a maze almost, it looks like, kind of thing.

Lydia: Yeah. And so it's the sort of thing that especially if you have kids who are getting really stressed out, then this is the sort of thing that they'll just get really mesmerized watching it. And you know when it runs out then you just turn it over and it goes again.

Tim: Right. Oil-drip timer.

Lydia: Yeah. It's an oil-drip timer. So, if you go my website, which is autismunderstanding.com.au, then I have my favorite resources page, and that has a huge list of these sensory toys.

Tim: Oh, brilliant. Brilliant. Thank you.

Lydia: So I've tried to find at least two places to buy everything.

Tim: Right, that's really good.

Lydia: So other things that you might be interested in. So there's things like...this is all about texture. You know how a lot of kids are into tags. A lot of kids with autism wanna have their tags cut off all the time.

Tim: On the clothing?

Lydia: On clothing. Yeah. Because they're quite sensitive to the touch of it. But I was thinking about this in terms of like if you're doing a piece of music, then because you want to try and include other senses, then you can get them to find a piece of material that feels like the music, so they can listen to you playing it and then find...You know, "I think it's like this rainbow one because, you know, it has all these different knights in it" or "it's a bit of a bumpy piece of music," so, you know, they might like this one with the bumps on it or whatever. So then they can try and recreate the same feeling. Does that make sense?

Tim: Yeah, it does. I think that could work for other students too, to be honest. I really like that connection.

Lydia: That's actually the same kind of idea used in reading recovery as well. So, getting kids to have like a smooth...The way that they're reading rather than it being bumpy, that kind of thing. So it'll have kind of a rough texture and then a smooth one and they'll say, "Let's try and make it smooth this time," that kind of an idea. Yeah.

Tim: So what on earth do you call that thing that you're holding?

Lydia: I picked this up at an autism conference. It's called Calming Moments. And it'll be on my website as well. But, yeah, there's lots of these kinds of things.

Tim: For those listening and not watching, it's a tactile cloth-based product with lots of tags of different colors and feelings.

Lydia: Yeah. And all the materials are different textures.

Tim: What a great idea.

Lydia: Yeah. So they can find something that makes sense to them.

So then, the other things I was thinking off, if I show you some of the things that I use for kids who have trouble with reading and handwriting because you might need the same kinds of things for playing the piano.

Tim: Definitely.

Lydia: Yeah. So these are jumping frogs. Have you seen those before?

Tim: No, I haven't.

Lydia: No? I'll just pop them on here for a second. So you push down, and they jump.

Tim: That flew a long way.

Lydia: Yeah, it does. It jumps quite a long way, and you can make them jump over each other. And they come in a bucket, so you can try and hang them into the bucket. And we races on the floor and that kind of stuff. So it's really good.

Tim: I wanna play with it.

Lydia: Yea, yeah. Yeah, coming to my office is fun. So something like this frog, that's all about building out this curvature in your finger. So you probably want that on the piano rather than...A lot of kids will do this.

Tim: Yeah, yeah. All piano teachers will know this issue. Yeah.

Lydia: Okay. So there's often a problem with handwriting as well. The kids who, if their parents are saying that they have trouble with handwriting, often that has to do with ligament laxity. So occupational therapists can help with this as well, but...So what you're trying to do is get them to push down with their finger curves like this to make them jump, and it's not gonna work if they do that because it's not getting the same kind of power.

So my son who has problems with handwriting, when he first started to draw, he was trying to hold his fingers still to make it do that because he didn't have the control. Yeah. And you might know this too. Like the kids who have handwriting difficulties and don't have that control in their fingers, they'll often have long fingers.

Tim: Yes. I've noticed that.

Lydia: Yeah. So my son who has dysgraphia, so the handwriting issues, we used to joke that he was gonna be a piano player when he was a baby because he had quite long fingers. But actually that's not a good sign.

Tim: No. Not necessarily.

Lydia: No. So what happens is your ligaments grow, sorry, your bones in your fingers grow until your ligaments stop them from growing. So if you have loose ligaments, then you'll end up with longer bones in your fingers.

Tim: Ooh, how interesting. I never knew that either. I'm learning so much today.

Lydia: Good. Good. Yeah. So the ligament laxity is a problem if you're trying to do handwriting or piano, those kinds of things, because it means that you're not getting as much feedback in your fingertips, which should be important.

Tim: Absolutely.

Lydia: And so what happens is then if you're trying to hold a pencil or pen, then, you know, you won't have that curve. And so if you're not getting the feedback and you think you have to hold on really tight, and so...

Tim: And that's when the last joint tends to bend backwards.

Lydia: Yeah. Yeah. So you'll tend to get that kind of thing happening with the pencil. But also, just generally holding on really tight and your hand gets really tired really quickly, and you tend to have pain in your fingers. It's a mess. Yeah. So you can use the frogs for that. You can also use stress balls. So this is a stress TARDIS.

Tim: So this was like the Doctor Who TARDIS.

Lydia; It's a Doctor Who TARDIS, yeah.

Tim: And it's made of that squashy foam stuff.

Lydia: With this squashy stuff, yeah. So you can definitely use that if you wanna build up kids...strengthen their hands. Like, that can be really good for handwriting and piano playing, I imagine. But there's a better stress ball. So this one, oh, this one is a bit cold at the moment, so it's a bit hard to get the fingers into it.

Tim: So this is a really hard foam.

Lydia: Yeah. So it's not foam at all, it's actually got clay. It's rubbery on the outside, and then it's got clay in the middle. And so it really resists you. So if you try and dig your fingers into it, then you can see that I've kinda made a dip it. So this is really good for grip strengths, and so that'll build up their muscles in their fingers as well. So you can use this kind of thing. So what you're looking for is a stress ball that has clay in it, so I found that one.

Tim: I've never seen that before.

Lydia: Yeah, most of them have the foam, and that'll be helpful a bit but a lot of them don't fight very much, so you need something that's really gonna fight back. Yeah. So that's listed on my website as well.

And other things that you might get parents to get the kids to play with are things like water guns so that they're doing that group strengths. Or giving them a spray bottle and getting them to paint the fence with water, that kind of idea. So they're getting the strength that way.

Tim: Yeah, right. So I didn't realize that the finger strength can be quite an issue for these students.

Lydia: Yeah. So a lot of kids who have learning difficulties often have trouble with their fingers. Yeah. And kids with autism often have trouble. They're not often, but a lot of them would. So that's something you might wanna check for.

Tim: All right, let's change tack for a bit.

Lydia: No worries.

Tim: In the blog post, again, you mentioned that it's sometimes necessary to be quite direct with students. And as piano teachers, we're very good at being calm and supportive and everything, but maybe that's not always the right thing to do. Can you give us some examples?

Lydia: Yeah, yeah. So you're probably used to being quite chatty and conversational with kids, and that would work really well with most kids. You know, saying, "Oh, isn't it a lovely day?" And , "What did you do on the weekend?" And, "It's school holidays, what are your plans," and all that kind of thing. With kids with autism, often that's just increasing the load of language processing they have to do. And so they're already having to work really hard before you even get near a piano. And so, they might get quite tired and grumpy with you if you're asking them lots of questions.

So what you would wanna do is sort of cut that out, which seems really abrupt. Like you would just say, "Sit down," and then wait for them to sit down, and then you will tell them what you wanna do, you know, that kind of thing. And just keeping to kind of instructions and not doing the chitchat. So when I worked at the school for kids with autism that was something that I noticed the most. All the new teachers that came, they we're doing so much talking, and we would video tape them and get them to see how much chatting they were doing and then get them to watch someone who'd been working in the school for a while and see what they were doing. So they would often just give an instruction and then wait and then they might just say a keyword rather than chat, chat, chat, or keeping on repeating the instruction over and over. Yeah.

Tim: Music teachers all talk too much. We all know it. We all know we shouldn't but we all do it.

Lydia: Most people do.

Tim: Yeah. But I think we're particularly bad because...Or maybe it's just me. But, you know, I've got a great relationship with my students and it's just easy to chat. And they know it. Some of them will be like, "Okay, okay, I'm gonna keep Tim chatting because I'm not gonna have to do what I need to do."

Lydia: Oh, I say that all the time with my son. So he's very verbal and he's not on the spectrum, but has dyslexia and stuff. And so he has math tutoring because he has math disorder as well, and he constantly is trying to derail, because the more chatting he does with the tutor, the less math he has to do. Yeah. So I think he's worked that out pretty quick as well.

Tim: Now, what about rewards, are they helpful for autistic children?

Lydia: Yeah, absolutely. Absolutely. Well, it works for other kids too.

Tim: What kind of things work? Oh, sure they do. Yeah. What kind of things can work as a good reward system?

Lydia: Okay. So one of the things I was thinking about. If you have kids who are wanting to do basically free play on the piano because the piano is a sensory toy itself, you know, and they can...I think the problem that you might have trying to teach them to play piano is that they might think they already know how to play the piano because they can strike it and get notes out of it. And so what you're trying to do is teach them a more controlled way of doing that and, you know, making it sound like music and all that stuff.

So they might be like, "Oh, no, no, just get out of my face. I'll just play the piano." So you could call that free play, and so I would have that as a reward at the end. So they need to get all their jobs done first, so they have to, you know, do their scales and practice pieces or whatever you're working on, and then at the end you might give them a minute or two of free play. So I have a picture of that.

Tim: Yeah. Show us.

Lydia: So this is another one of those visuals. So this one I was thinking you might have...I'm just guessing, things like scales. So to me the scales is like a rainbow like, going up the notes and then coming back down again. And so you would want to make sure that you can hear all the colors in the rainbow.

Tim: Nice visuals, I like it. Yeah. I'm impressed, Lydia. You know, you're not a piano teacher and you're making some great connections here.

Lydia: That's great.

Tim: You're giving us great ideas.

Lydia: I did have some piano lessons a long time ago when I was in year 11 and failed it miserably, probably because I didn't practice at all. But yeah...

Tim: That didn't help.

Lydia: Well, at least I have that understanding of what it could have been.

Tim: Sure. So again, you're saying these could be cards that are on the piano [Crosstalk].

Lydia: Yeah, yeah. So you might have a little strip and you might, you know, pick out the ones that you want to use today, that kind of idea. Yeah. So you can just have a strip of Velcro and then have the pictures with a bit of Velcro on the back and then stick them on in the order that you want them. And so, yeah, so we've got the scales. And then we might have the "Saints Go Marching." So we've got a picture of a little saint person with wings and some marching bits.

Tim: Very creative, Lydia.

Lydia: Oh, this is the joy of working with kids with autism.

Tim: It's great.

Lydia: It hasn't really helped my artistic ability at all, but I just pretend.

Tim: I think you've done very well.

Lydia: Pretend I can do these things. And then I remember when I was doing the piano, we had this piece of music called climbing, where you had to cross your hands over and go all the way up to the piano. So you might have a ladder, so you have to put your hand over hand when you're going up the ladder to remind kids to do that. And then there might be something in their book, so they might do some theory and then we've got free play at the end. So they can see the free play is coming, but we have to do these things to get there. Does that make sense?

Tim: It does.

Lydia: Yeah. And then what you could do is if you wanted to, you could use that for the lesson plan, and then you could put it in their book and you could use it to remind them of the homework that they need to do. So if they get all their homework done, then they can have free play at the end as well.

Tim: It's great.

Lydia: Yeah. And you can put their notes in there about what they have to remember or whatever. But that's probably gonna work better for them to remember what they're supposed to do than just a list of words about what they have to do.

Tim: A number of the other guests said that a visual representation of the structure of a lesson can be a fantastic thing.

Lydia: Yeah, yeah. Definitely. Yeah. And I guess the other thing what we were talking about with kids being quite literal. So often we'll think that it's not polite to tell kids to stop talking, it's absolutely essential to tell kids to stop talking if they have autism. Because they're not gonna read body language, so often with typically developing kids you'll say, "Okay." Or you might look at your watch or you might sigh if somebody is talking too much. A kid with autism has no idea why you're doing it. They don't know it has anything to do with them. Even if they notice, they're not gonna necessarily, and that means they have to stop talking. And so they might actually think that you're getting bored and so then they'll tell you another really cool thing about their interest to get you interested again. So it might actually increase the talking if you do that. So you need to say, "Stop talking now."

Tim: Like that, not, "Would you please, would you mind?" Just, "Stop talking."

Lydia: Listen to how many words you're using. Yeah. So, "Would you mind?" "It would be great if you could..." You don't need it. You just wanna say, "Stop talking."

Tim: Which seems really abrupt to us.

Lydia: It seems really rude, but actually, kids will appreciate you being clear with them because then they're not having to do all that work to work out, "So what is it you want, again?" Because if you say all that, "Would you mind. You know, the lesson is getting late and I think, you know, your mom wants us to actually get on with things." They have no idea what you're talking about. Yeah. So you just need to say, "Stop talking." And then I would say things like, if you want them to...Or you might say things like, "Talking is finished. We're doing scales," something like that.

So you're telling them what they are gonna do. So it always works better if you tell them what you want them to do rather than what you don't want them to do, because if you say like, "No banging on the piano," then they've just heard the word "banging" and they go, "Yay, banging." So they'll just keep going. They might miss that "no." It's important, you know, and particularly if it's "no hitting." You know, that kind of thing, you don't want them to miss the "no" in that.

Tim: And one other thing you mentioned was don't give instructions as questions.

Lydia: Oh, no. No, no. "Would you like to come and sit down at the piano?" No. No.

Tim: Sit down at the piano.

Lydia: So if you want them to sit down, "Sit down at the piano." And then you just wait, and then you might say, "Sit down." Yeah. So, yeah.

Tim: Great tips, Lydia. I know that the listeners are gonna find this really, really useful. So look, we're getting close to starting to wrap up. Just a couple more questions for you. What about group teaching, so managing ASD students in a group context? Maybe it's something that should be avoided, I don't know. What are your thoughts?

Lydia: It kind of depends on what the goal is. So I guess if the goal is to get them really good at the piano, then, you might wanna have then one-on-one, possibly, because they might progress at a different rate then the other kids. But if the goal is around them being able to follow a group and take turns and listen to others, and make a friend, that kind of stuff, then the group thing might be great. So then, you can still use the structure.

So you could still have this kind of lesson plan but use it for everyone. Because the thing is, like you might also have a kid with ADHD who's missing instructions, the visual is gonna help them. You might have kids who are anxious and they would like to see what's gonna happen next. You can have the kid who's too busy talking to their friend and miss the instruction. So it's not gonna hurt anyone, really, to have that kind of stuff.

And then you might have like even, you know, the list of rules about how we do our class or whatever. You might, you know, happen to the tapping that more for one child than others but it's for everyone. So then they're not getting singled out.

Tim: So I think that's what I'm picking up from you is if the goal is to give the student an experience in a group and build those social skills, then whatever you do, do it all for the whole class and don't make it clear that you're doing something for that student.

Lydia: Yeah. I think that's often the mistake that teachers can make is that they think, "Okay, I've got my lesson planned, and then I need to have a whole another lesson planned for my child with autism in the class." And so rather than doing that because that's twice as much work, you wanna think about, "How can I make the lesson plan for the whole class more visual? How can I get them to do some movements so that, you know, we're not sitting the whole time" and that kind of thing. And the rest of the class is gonna enjoy that as well. So yeah.

Tim: And my last question is in regard to special needs more generally, we've focused on autism today, and I say, a lot of the guests have...that's been their experience. What about our students with Down syndrome, intellectual disabilities, ADD, are the themes that we've been talking about, are they things that you can try with all those different types of students, and do you think that would have a good effect on the whole?

Lydia: Yeah. So I see kids with Down syndrome and cerebral palsy and ADHD and lots of other things, lots of genetic disorders and all that kind of stuff. So visuals don't work very well for visual impaired kids, obviously, but other than that, they tend to work really well.

Tim: And the same for toys, too?

Lydia: Oh yes. Most kids like toys.

Tim: I wanna play with those toys.

Lydia: Yeah. Yeah, yeah. And I was thinking too, like, if you had a kid who every time they got on the piano they just wanted to do their own thing, and you wanted to teach them how to copy you, then you might wanna use something that doesn't actually make any sound. I know that seems strange for a music class, but I was thinking like have these little pirates. And so you might have a little pirate quiet...

Tim: This is like the Russian dolls or whatever they're called.

Lydia: Yeah, like the little Russian doll. Yeah. So if you did like each of the little people, they might make their own sound or they might, you know, they might say, "Walk the plank," or, "Arrr" or something. And so then what happens is then the kid would need to learn from you like he might do a choral response kind of thing. So you would make the pirates do something and then they would need to copy you. So they can't just bang on the pirates to make noise because they're not actually a musical instrument themselves.

So they do need to pay attention to you to find out how they work. And then being pirates. You're the pirate captain. So if they decide that they're gonna play the pirate some other way, then, you're saying, "No, no, no, I'm the captain." You're the first mate. You have to do what the captain says." And so you get them to do it that way. And because it's pirates, then, you know, that would be fun. So once they get used to copying you, then you can get them to copy you on the piano.

Tim: Right. So that's a little bit about story, making connections with stories.

Lydia: Yeah, yeah. And sort of finding things that the kids are interested in. So like if you have someone who's obsessed with Ben 10, then, you know, he has some friends, and so you can say, "Well, you know, if Ben 10 was learning the piano, I bet he would do blah, blah, blah." And so then it's Ben 10-related and then they're more likely to pay attention.

Tim: Yeah. Makes a lot of sense. Lydia, it's been awesome speaking to you. Thank you so much for giving your time and advice so freely. You're the absolute expert here. Is there anything that I've forgotten to ask you that we've missed?

Lydia: I don't think so.

Tim: Any more toys to show? No, that's all right.

Lydia: I do have one more.

Tim: Okay, go on, one more.

Lydia: So this one, it's another one of those for fingers. So this is called Tricky Fingers. So it's got little balls inside. This was designed by an OT, an occupational therapist. And so what you're trying to do is you're trying to make the balls match up with the pictures so that you get all cards. So you can't move the balls from the top because there's this glass up or something, and you can't get those out, which is good to know because kids with autism will try. What happens is there's holes in the back, so you're actually, you're looking down on it but you have to use your fingers to move the balls around.

This is really good for kids who have trouble with getting the feedback on what their fingers are doing. Like if you talk to OT, it's often what they'll do to test this kind of thing. They'll cover up kids' hands so they might...Say I've got my hands here, they'll have a piece of paper like that so I can't see my hands, and then they'll do a thumbs up or something like that and I have to copy it. And kids who have trouble with knowing where their hands are, they can't do that. They have to see their hands to be able to do it. Yeah. So if you have kids who have that kind of trouble, then something like Tricky Fingers is gonna help them to know what their fingers are doing.

Tim: And it's called Tricky Fingers.

Lydia: Tricky Fingers. Yeah.

Tim: It's great.

Lydia: And it's on my favorite resources page of my website.

Tim: Okay. So we'll probably link to your resources page in the show notes. And just remind everyone, where can they find out more about you?

Lydia: autismunderstanding.com.au.

Tim: Fantastic. And you do a lot of speaking around the place so there's good chance...

Lydia: I do. I do. Yeah. I travel around and I run workshops for teachers. So, piano teachers are very welcome to come along to my workshops. So I run two-day practical autism strategies for teachers, workshops.

Tim: Oh, brilliant. Have you had many independent music teachers at them before?

Lydia: No. I've had some yoga teachers but, yeah, not often. I've had high school, primary school, early childhood, and speeches in OTs, psychologists coming.

Tim: Great. Well, let me know when your next one is happening, and I'll make sure I let my viewers know so we can...Yeah.

Lydia: Cool. Yeah, I've just finished my round of training around Australia, but I'll be coming back next year. So it's usually in term two and term three. So the dates will be on my website as well.

Tim: All right. Thank you so much, Lydia. I'll let you go and enjoy the rest of the day. I really appreciate your time.

Lydia: Thank you.

Tim: Thank you. See yah.

Lydia: Bye.