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Introduction
to
May I
Join You?
Encouraging social
communication
through play
Strategies to help adults find
ways to join a child's play,
interests and enjoyment.
For children who are pre-verbal
or at the early stages of language
development. Age 1 - 6 years.
Contents
1. Who is this resource for? ……………………………………………........................ 2
2. Welcome to 'May I Join You?' ………………………...…...………..........................3
3. About communication development .......................................................................4
4. Why play? ………………………………………........................…….…...................9
5. How to use this resource …………………………………………….…...................10
1. Who is this resource for?
The adults:
This resource is suitable for anyone who wishes to help children with social communication
difficulties to interact with others. It is intended for people who work with young children,
but have not had extensive training in promoting social engagement in children with
communication difficulties. It is anticipated to be relevant for early years teaching staff,
nursery classroom assistants, independent nursery staff, play workers, health care
workers and other people who work closely with children with social communication difficulties
and their families. Parents of children with communication difficulties may also find these
ideas useful, as may teenage brothers and sisters.
The children:
These strategies are suitable for children with a wide range of communication difficulties and
developmental ability, including children with mild to severe difficulties. As a guide, May I
Join You? strategies are suitable for children between one and six years of age, who are not
yet talking or are in the early stages of speech development. However, the strategies can be
adapted for younger, older or more verbal children.
This resource often refers to the child as “him” or “he”. However, it is equally applicable to
girls and boys. When we talk about “your” child we mean your child or the child you work with.
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2. Welcome to 'May I Join You?'
May I Join You? is a resource developed to help adults help children with communication
difficulties. It gives information and strategies to use during play, which encourage social
engagement and communication, and is designed to help when children are showing
difficulties with communication early in their development.
The resource includes:
•
•
•
•
this introductory booklet
the May I Join You? Play Strategies book, suitable for use during play
a DVD that explains and illustrates examples of the strategies
a 'Reflections Record' sheet to help you record and think about your play sessions
A starting point in encouraging children to enter the social world around them is to join in
with their world. Children with communication difficulties need us to do this a lot before they
begin to be interested in interacting with others. As the name suggests, May I Join You? is
about how adults can seek to join a child in their interests and play. Implicit in May I
Join You? is the understanding that to be allowed to enter the child’s world we must try to
do so ‘respectfully’, with awareness of their individual sensitivities, communication style,
interests and needs. By helping children to share their play with an adult, we give
them opportunities to experience social interaction, learn from it, and develop their
communication skills.
The strategies outlined in May I Join You? are widely recognised to promote social
engagement, and have been included in a number of therapeutic programmes, including
Preschool Autism Communication Therapy (PACT; Green et al., 2010). Families in Gwynedd
and Anglesey have participated in PACT over the last few years, and this resource is based
on the strategies that they found useful, not only for children with autism, but for children
with any kind of communication difficulties. This approach is compatible with the more
general parenting and educational approaches, such as the Incredible Toddlers programme
(Webster-Stratton, 2011), whilst providing additional information for children with early
communication difficulties.
May I Join You? strategies aim to help the child to:
• pay attention to an object or event together with an adult (often called 'joint attention'
or 'shared attention')
•
•
•
•
•
•
start periods of shared attention himself
enjoy interacting with another person
experience being understood by an adult
experience an adult being 'in tune' with him
play for longer periods
listen to an adult and develop his understanding of language
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3. About communication development
What do we mean by communication?
Communication means the ways we ‘connect’ and interact with other people to share
information, thoughts, feelings and intentions. Of course, one way we do this is through
speech and language, but communication includes much more than this. Imagine yourself
in the hospital emergency department in a country where you have no understanding of
the language. You watch someone come in and explain to a nurse how they got injured.
The chances are you would be able to get an idea of what has happened and how they are
feeling. Think about the many clues you would be given. Communication includes body
language, such as facial expression, gesture, direction of eye gaze, body proximity,
voice intonation, pitch, speed and volume.
What happens in typical development?
When a child is developing typically, spoken language only begins when a child is already
able to communicate some of their feelings, thoughts and intentions to others without words.
From a very young age, babies make noises, facial expressions and actions spontaneously.
Adults naturally respond as if the baby was talking to them.
For example, a young baby squeals on the changing mat. His mum ‘tunes in’ and replies
with a similar squeaky sound. Baby realises that he has made Mum make the squeaky
noise, and makes the noise again, this time on purpose, to see if she will respond again.
She does, and they have a little ‘conversation’ of noises.
These interactions happen continually through the baby’s first year. Because parents
treat their baby’s behaviour as if he had intended to communicate, baby begins to try
out intentional communication. The parents and child develop a dialogue, made up of
movements, exaggerated facial expressions and sounds, alongside the parent’s spoken
language. Baby and adult both listen, watch and wait for each other’s contributions to the
‘conversation’. In this way, over their first year, babies learn and practice how to have nonverbal ‘conversations’ with an adult, and appreciate how useful and enjoyable it is.
When speech starts in their second year babies have the relatively straight-forward
job of slotting words into these non-verbal conversations.
A useful analogy is the importance of having firm foundations in place before building a
house. Babies usually develop the solid foundations of communication: an awareness of
others, a desire to communicate, listening, waiting, turn-taking, memory, attention,
symbolic play and eye contact; before building the ‘house’ of understanding, expression
and speech sounds.
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When communication development is atypical
When a child’s communication does not develop in the usual way the process of building the
foundations for language does not go so smoothly. Consider the earlier example.
What would have happened if the baby on the changing mat had not made that initial
squeal? What if he had not been looking at his mum when he did it? The rest of that
‘conversation’, and the learning experience the baby had, may not have happened.
Children with communication difficulties do send out signals about their needs, wants and
interests, but their signals may be
• weak and hard to notice
• atypical i.e. unusual, not the signal we would expect them to give
• not directed at someone i.e. the child may appear to make a sound to the whole room or to an object, rather than to a person
• mis-timed i.e. signals are given too late or too soon, such as when the adult has moved or looked away.
This makes it harder for the adult to ‘tune in’ to the child’s communication and to understand
what they mean.
What are the types of communication difficulties and
what causes them?
Communication difficulties may appear at an early age or might not be clear until a few years
of age. Children may show difficulties with:
• using non-verbal communication e.g. using eye contact, using facial expressions
to show someone how they are feeling, using gestures such as pointing
• directing their communication to people e.g. when they are happy they smile,
but may not smile at someone
• sharing their attention i.e. paying attention to an item jointly with another person
• paying attention to people, language and social signals e.g. may not respond
to their name.
For some children it may become clear as they grow up that their difficulties are restricted
to only certain aspects of communication. After their initial language delay or impairment
their communication may go on to become completely functional. For other children
their communication difficulties may be related to a more general delay in their overall
development, sometimes called global developmental delay. These children sometimes
catch up, or may go on to have some degree of learning difficulties. Some children
who have severe communication difficulties, particularly with the non-verbal aspects of
communication, go on to develop in such a way that a diagnosis of autism or autism
spectrum disorder (ASD) may be appropriate. Autism is a neurodevelopmental disability
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that affects language, two-way interaction with another person and play interests. It is seen
as a ‘spectrum’ condition, with some people being more mildly affected than others, and
people are generally affected throughout their lives.
The causes of communication difficulties have not yet been established. Research suggests
that a number of conditions that affect brain development before, during or after birth can
cause communication difficulties. There is also some evidence to suggest that there are
genetic causes, but the specific genes involved have not been identified.
Impact on behaviour
Communication difficulties can have a big impact on the child’s ability to connect with people
and signal what they need or want. This is often frustrating for the child and adult alike, with
the child being unable to tell adults what they want, and the adult being left guessing what
the child wants.
What's it like for the child?
For a child with limited understanding and communication the world can be a confusing
place! All around them people are using gestures, facial expressions, body position, tone of
voice and spoken language to communicate. Compared with another child of the same age
and intellectual ability, the child may not fully understand all of what is going on, and may
misinterpret signals too. The child may feel bombarded by signals and overwhelmed at the
task of trying to work everything out all at once. Children respond to these feelings in many
diferent ways, and may try to control or reduce the demands upon them. For example,
some children will insist on things being a certain way, others might withdraw from what's
going on and 'do their own thing'.
For the child, everyday events can seem unpredictable. For example, a child may
experience his mum hurriedly tidying away his toys, and then putting him in the car as
happening 'out of the blue', because he did not understand her warning a few minutes
ago "we're going to see Auntie Anne soon". Not knowing what is going to happen,
when and why often makes people anxious, and children may respond with
distressed or angry behaviour.
Children with limited functional communication sometimes realise that,
because adults are 'tuned in' to keeping them safe, they can get an
The child
instant and predictable response from an adult by doing something
does not give
that the adult finds unacceptable. For example, a little girl wants
out communication
an adult to play an exciting game with her. She climbs onto the
signals in the
windowsill, sure in the knowledge that Dad will rush over to
usual way
her, hold her, and swing her down (a sensation she loves).
This quickly becomes a fun game for her, but her dad finds
it frustrating, and feels she knows it is wrong and is doing
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e
ex
ta
c
it on purpose. She is doing it on purpose, in order to engage with her dad, but has little
understanding that her dad does not want her to do it because it is dangerous or not allowed.
In such situations, the child may have given ‘their’ signals that they want to play with
someone or need help settling to play, but these may have been weak, unusual, mistimed or not directed at someone, and were therefore missed. For example, before
climbing onto the windowsill, the little girl above had repeatedly walked in and out of her
pop-up tent, where her dad would usually play an exciting hide-peep game with her. She
had not vocalized, gestured or looked at him, so understandably her dad did not interpret this
behaviour as her asking him to play. However, with hindsight he thought that this is what she
had been trying to do.
What is it like for the adult?
If you are an adult caring for a child with communication difficulties it may sometimes
feel like the child is rejecting your efforts. You may feel that the child doesn’t like you,
or prefers to be alone, or you might worry that you aren’t very skilled in being with young
children. You may respond by giving up trying to connect with the child, or you may try
extra hard to connect with him, and feel frustrated when you don’t get the response you
were hoping for. The child may play on their own more than you would like, and gets fewer
opportunities to learn about and practice being together with another person.
Figure 1: Possible patterns of responding
when a child's communication is atypical
The adult tries
very hard to engage
with the child
e.g. talks louder or with more
excitement to get his attention,
talks more, offers more toys,
controls the play to teach the
child how to do it
The adult
assumes that the
child wants to be
left to do their own
thing, so leaves
them to play
alone
The child
becomes
overloaded with
stimuli and moves
away or disengages
from the
interaction
The child
misses
opportunities to
learn about people,
communication
and interaction
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Sometimes it might feel that getting him to do even the simplest things, like putting away
his toys and going to visit a relative, end up with him getting upset and
you feeling ‘frazzled’. These are hard feelings to have, especially
about your own child or a child in your care. It may help to
The child
remember that the root of the problem is the child’s difficulties, that
does not give
out communication
are likely to have a biological cause. It's not your fault, and it's not
signals in the
his fault! 'Difficult' or puzzling behaviour probably isn't because
usual way
he wants to be awkward or doesn’t want to be with you, but
because he doesn’t have all the ‘tools’ he needs to communicate
and understand, and that makes being with someone and doing what
they want harder. Although understanding this doesn’t solve the difficulties for you or
the child, keeping this in mind might help you to think through how you would like to
respond to his behaviour.
How can we help?
As a child develops, before they can join in with the social world around them, they need lots
of experience of adults joining in with their world. Children with communication difficulties
are no exception, but it is much harder for them to let an adult join them. We can help them
by working out ways that enable the child to let us join them in their play and interests.
Adapting the way we approach play with the child can help him practice learning about
people and sharing his world.
The May I Join You? Play Strategies booklet gives well-established ideas and tips on the
things you can try out with your child. You might notice that some of the strategies are things
that you might naturally do to engage with a younger baby or toddler, without even thinking
about it. These strategies help children build their communication skills whatever their age,
but we often forget to use them when playing with an older child! When a child is older and
is more developed in other areas of functioning it is easy to assume that he understands and
has more skills in communication than he actually has.
The strategies are all about watching the child and giving him the chance to show you
about his interests and existing communication signals. They involve finding moments
and little ways to join in with him that he likes. You can join him by simply looking at what
he is doing, admiring it and making comments or interesting sound effects. Together you
are both focused on the same thing. Mirroring or copying his activity will bring the two of
you together doing his chosen activity, without you having to interfere with his play. Another
way to join his play is to try to work out what he wants to achieve, and help him to achieve
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The adult finds
ways to give the
child the best
chance of sharing
their play
The child is
able to spend
more time
engaged in shared
play and interaction
The child has
more opportunities
to learn about people
and communication
Figure 2: How we can help when a
child's communication is atypical
his goal e.g. handing him the bricks to throw in a box, helping him join his trains together.
There will be chances for you to interpret and respond to his behaviour as though he were
talking to you.
In these ways the child gets to experience and practice what it is like to ‘connect’ with an
adult, and how rewarding it can be when someone understands their interests and
intentions. This helps the child to learn the value of communication and builds the
foundation blocks for later language development. Some forms of communication
difficulties are lifelong, but even small improvements in the child’s ability to communicate
and share their experiences with others early in their development is likely to have a
lasting impact.
4. Why play?
Before looking at the play strategies it may be helpful to review what play is all about.
Play is:
• freely chosen: it is what the child wants to do right now!
• intrinsically motivated: children play for the sake of playing, not for the sake of achieving a goal.
• personally directed: the child controls what they do and how they do it
Play is not: being taught how to do something.
However, free play provides wonderful opportunities to learn about the world and is an ideal
space for children to develop social communication skills. Through play, children can
experience and practice sharing their attention with another person, different ways of
connecting and communicating with a person, and experience different emotions in
themselves and others.
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5. How to use this resource
When and how often?
It is widely recognized that building spontaneous and useful communication skills is central
to treating and educating young children with communication difficulties. Giving children
opportunities to develop and regularly practice their functional communication throughout the
day will help the child to engage with others and in their future education.
These strategies are not intended to replace existing education plans or play activities, but
can be built into a child’s day in a number of ways. To begin with it might be helpful to have
a discreet 15-20 minute period of ‘special play time' each day where the child and adult can
play, one-on-one. A place with as few distractions as possible is ideal. It may be helpful to
signal the start of special play time to the child e.g. by putting a certain blanket on the floor.
During special play times you can focus on using these strategies, starting with the earlier
ones, and gradually building in more as you feel ready. You will find out which strategies
help your child to engage in shared play and interaction. As time goes on you may feel it
appropriate to use these strategies for longer periods or at other times, beyond your special
play times.
What toys?
Laying out a few toys for the child to play with is helpful. In most cases it is best to offer
only two or three simple toys (e.g. a pop up tent, a cushion and a pair of drums). Below
are examples of toys that can work well in terms of being enjoyable for the child, and offering
opportunities for to-and-fro interaction. Once you have found toys of interest to the child, you
could create a special box or bag of them, and get them out at the start of your play, to show
that it time for special play.
•
•
•
•
•
•
•
•
•
•
Pop up tents, blankets, cushions
Balls, balloons, bubbles
Cause and effect toys
Sensory toys e.g. water play, silky or fluffy scarves, crinkly materials, rain sticks,
sensory ‘rollers’, textured or noisy balls
Musical instruments such as drums, tambourines, toy ‘echo microphones’
‘Squishy’ plastic animal toys, dolls or human figures
See-through filters or fabric, kitchen roll tubes
Spinning tops, stacker cups
Garage and vehicles
Inset puzzle boards
Having two of each type of toy can be very helpful; one for the child, one for you. This way
you can copy the child’s actions without having to interfere in what he is doing.
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If this works with the child you are working with, try having two bags/boxes of identical toys,
one for you and one for the child.
What if the child gets very engrossed in toys?
Many children become so engrossed in toys that they are too busy to notice the adult seeking
to join them, even after they have had plenty of time to settle down and explore the toy first.
If the child you are working with gets very engrossed in toys, try playing without toys, with
soft blankets, cushions, pop-up tunnels or tents. Try hide-and-seek, tickle or chase games if
he is in an energetic mood, or more gentle activities such as lap games, stroking or singing if
he is in a peaceful mood.
What about repetitive play?
Sometimes a child may only be interested in a repetitive activity, such as banging something that makes an interesting noise or looking at his toy cars. Is there a way you can
share his experience? Seeking to join the child in whatever he is interested in will enable
him to have the feeling of sharing his experience with another person, and will build his trust
and confidence. He may well be more interested in your company next time! For example,
one little boy found it hard to play with another person and started his special play sessions
by running his toy car up and down the radiator. His parents felt this was because he enjoyed
the sound it made. His dad found that if he joined his son in running another toy car up and
down the radiator, copying his rhythm and energy level, his son began to notice him, and
gradually a connection would grow between them. This enabled the little boy to let his dad
follow and join him in other play activities.
A note about sensory issues
It is important to be aware that some children with communication difficulties have difficulties
with sensory experiences. For example, some children are very sensitive to certain noises,
textures, tastes, smells, movements or touch, and may find some sensations unpleasant and
hard to tolerate. It might be helpful to think about these things before seeking to join your
child's play.
What if he doesn't seem to want to play with you?
When you first start your special play sessions you may find the times that you are able to
share his interests are very short or subtle. Don't worry, this often happens! Think about
the few moments of the play where you felt most connected with him, where the play felt
easiest or most enjoyable. For example, you may have felt most 'at one' with him when he
was lying on the floor pushing his train backwards and forwards and you were able to watch
for a few moments before he turned away. What did you do that helped you have
those moments where the two of you shared his interest? Was it because you lay
11
down too, a good distance away? Was it because you just watched him with interest, and
didn't try to join in more actively? Was it because he liked it when you said "choo choo" as
his train moved? Could you use those strategies more next time?
After play session ‘reflections’
You may find it useful to think back on how each play session went, and what you did that
helped the child share his interests with you. This resource contains a ‘Reflections Record'
sheet, to help you think about and record your sessions. This is also
summarised on page 14 of the Play Strategies book.
You might consider video-recording your play sessions
(with the permission of the child's parents of course).
Watch and re-watch the video and review the
strategies you tried that worked well. Video-recording
will enable you to notice the child’s more subtle
communication signals, and how you helped him
to let you join him. You could also ask a good friend
or colleague to watch you play with the child, and
discuss it afterwards. They may have noticed things
you did that helped the child to share his play with you.
Play is playful!
Be prepared to try
things, even if they
seem silly!
Try to 'go with the flow'
and enjoy being part of
your child's play.
If you are relaxed, he will
feel more relaxed and
ready to learn.
What works will be different for every adult and child pair.
Using May I Join You? strategies isn't about what is right or
wrong, but about finding what works.
May I Join You was developed through a grant from the Gwynedd and Anglesey Autistic Spectrum Disorders
Steering Group 2014-2015 by Dr Helen Delargy, Clinical Psychologist, and colleagues. Helen has worked with
children with communication difficulties and developmental disability in Gwynedd and Anglesey since 2002.
Acknowledgements
Thank you to the families and teaching staff who have worked with us over the last few years; you have taught
us so much about using these play strategies. Special thanks to the parents, children and teaching staff that
allowed us to film their special play times for this resource.
References
Green, J., Charman, T., McConachie, H., Aldred, C., Slonims, V., Howlin, P., Le Couteur, A., Leadbitter, K.,
Hudry, K., Byford, S., Barrett, B., Temple, K., Macdonald, W., Pickles, A., and the PACT Consortium.
Parent-mediated communication-focused treatment in children with autism (PACT): a randomised controlled trial.
2010. The Lancet, 375(9732): 2152-2160.
Webster-Stratton, Carolyn. Incredible Toddlers: a guide and journal of your toddler's discoveries. 2011,
Incredible Years, Inc. Seattle, USA.
For further information
Afasic Cymru. Afasic Cymru is a charity in Wales representing children and young people with Speech,
Language and Communication needs, including Specific Language Impairment (SLI). Information is available in
English and Welsh. www.afasiccymru.com
If you have any comments or queries about May I Join You? or if you would like a copy, please contact
Dr Helen Delargy, Derwen, Integrated Team for Disabled Children, South Road, Caernarfon, Gwynedd, LL55 2HP.
Email: [email protected].