Turn-Taking - Communication & Social Skills Toolkit (PDF)

Communication & Social Skills Toolkit Skill 10 Turn-Taking April 2021 What does turn-taking mean? Turn-taking is a critical social communication skill that moves far beyond simply sharing a toy with a peer or a sibling. After all, being able to take turns with items, activities, or even in conversation is important for everyone! Some examples of turn-taking include: 1. A very young child takes turns pushing a toy car down the ramp with a friend or sibling. 2. A brother and a sister take turns using the swing set in the backyard. 3. Two preschoolers take turns riding the only tricycle around the playground. 4. Several elementary students take turns drinking from the water fountain after P.E. 5. A group of friends take turns playing a two-player video game. 6. Friends take turns in a conversation as everyone shares what they did over the weekend. 7. Co-workers take turns pitching in ideas for a new project at the office. Why is this skill important to teach? Turn-taking is a skill every person uses every single day of their life. Turn-taking encourages cooperation, creates a sense of order, and ultimately, fosters a sense of fairness, compassion, and respect for others. It’s easy to think of turn-taking as something that is really only important when it comes to playing with toys or games; however, turn-taking is actually a foundational skill that sets the stage for how we interact with other people. Infants are exposed to the idea of turn taking in the first few months of life. Think about what happens when a caregiver holds an infant. The infant smiles and coos as a way to get the adult’s attention. The infant then waits for the adult to respond. The adult then smiles and coos in return. This interaction keeps going back and forth between the infant and caregiver with just smiles and cooing. There is a back and forth nature to these interactions. This back and forth sets the stage for how a child learns the flow and rhythm of conversations and interactions with others. As very young children grow, they learn how to interact with people beyond just their caregivers and siblings. What the child learned about those earliest back and forth interactions is then applied to everything from taking turns with a toy to getting along with others to developing meaningful relationships. If a child does not have turn-taking skills, the child might resort to grabbing a toy from another child, ignoring social norms and rushing to the front of a line, or even try to monopolize a conversation and not stop and wait for the other person to contribute information or comments. Autism Center for Excellence  Why is turn-taking difficult for children with Autism Spectrum Disorder? Children with Autism Spectrum Disorder struggle with a variety of social communication skills, including the back and forth nature to communication and interactions. Very young children with ASD have difficulty with ‘tuning in’ to these earliest rhythms with caregivers. For example, an infant might not smile in response to a caregiver’s smile and might not coo back when the adult uses baby talk. As the child grows, he or she might not share an interesting item with their caregiver as if to say, “Wow, look at this!” Some children struggle to develop verbal communication and conversations can feel very one-sided with the caregiver doing all the talking. Other children with ASD might have large vocabularies and can speak quite well but may not engage in the back and forth that happens in a conversation. Rather, that child might spend more time ‘lecturing’ others on what they know rather than sharing information in a conversation. Because of these challenges, a child with ASD might struggle to fit in with others, have difficulty follow social norms and rules, and ultimately, have significant problems developing meaningful relationships. However, there are ways to support a child in learning this critical skill at any age! What are some considerations for teaching turn-taking? Before teaching a child turn-taking, be sure the child has an understanding of concepts like stop and wait but also an understanding of how to get a person’s attention. For more information on teaching a child these concepts, please check out the Waiting and Getting a Person’s Attention toolkits. Teaching turn-taking will also require a good understanding of your child’s preferences. In other words, it will be important to know what items and experiences your child prefers. Using items and experiences your child prefers helps encourage engagement and learning. Be sure to also consider a variety of people that your child prefers as practicing this skill requires the child to interact with someone else. Before starting, it’s also important to take into account how your child communicates. Some children with ASD use Augmentative or Alternative Communication (AAC) such as sign language, picture exchange, or even a device that speaks when a button is pushed. Other children with ASD can use some verbal speech but need support by using cue cards with a word and/or picture or by using a sentence strip or choice board with different options for greetings, questions, and comments. Be sure the child has the vocabulary they need to participate in this activity. Finally, because learning turn-taking is a complex skill, it will be important to remember that the child with ASD may need a lot of practice. It will also be important for the child to practice using turn-taking in different environments with different people and practice with a wide variety of items, activities, and experiences. What materials will I need? Families might need the following for teaching turn-taking: — Preferred and non-preferred items / activities / experiences / people — White board — Markers — Pre-printed visual supports to include cue cards or sentence strips  — For Augmentative and Alternative Communication (AAC) users, be sure the child has access to the vocabulary needed to participate including sign language, picture exchange items, or a communication device that is programmed with the appropriate pictures and words. — Since taking turns requires a child to wait in between each turn, some children may not have the ability to wait for several minutes at a time before their turn comes around again. In order to practice turn-taking with a child who has just learned waiting, start small and try activities with a short wait time. This might include activities like: £ Rolling / bouncing a ball back and forth £ Pushing cars down a toy ramp £ Building a block tower together — For this activity, consider the vocabulary a child will need in order to participate, such as stop, wait, my turn, and your turn. Some children may be using cue cards with these words while other children use sentence strips, white boards or choices boards with options that expand the language to include phrases such as, “Is it my turn yet?” Other children who use AAC will need to access to sign language, picture exchange items, or communication devices with options for participating in the activity. — Let’s take building a block tower together as an example. Sit down with the child and hold back a bunch of blocks in a bin. Take a block out and hold it up. — Tap your chest and say “My turn!” — Place a block on the floor. — Now grab another block and hand it to the child. Point to the child and say, “Your turn!” — Wait 5 seconds for the child to respond. — If the puts the block down, tap your chest again and say “My turn!” — If the child does not engage, prompt the child to add their block by pointing to the tower again and repeating, “Your turn!” — Repeat the steps over and over again as the tower builds higher. Try to end the activity before the child gets bored or wanders off. Activity #1: Teaching Turn-Taking -- Starting SMALL — Once a child responds to quick back and forth turns, try activities that will expand that wait time just a little bit longer. At first, try games where each turn is just a few seconds long and do not require a lot of language. Some initial games to try might include: £ Putting a puzzle together £ Connect 4 £ Don’t Break the Ice Activity #2: Teaching Turn-Taking -- Board Games  — Choose a video game that the child really enjoys but where only one person can play at a time and the iPad or game controller must be passed back and forth fairly quickly in between turns. Create a cue card, sentence strip, or choice board with phrases such as “Yes” and “Can I have a turn?” Let’s take an example of playing a game with a single controller. — First, ask another family member for help with this activity. — Hold up the controller and say, “My turn.” — After you turn is over, ask the other family member, “Do you want a turn?” — The family member can model saying, “Yes, thanks!” — When their turn is over, the family member should ask the child, “Do you want a turn?” — If the child responds, hand over the controller immediately. — If the child does not respond, prompt the child by: £ Pointing to the “Yes” cue card £ If the child uses AAC, point to a picture or a device button or model signing “Yes” — If the child responds by giving the “Yes” card, hand over the controller. — If the child does not respond, model handing the “yes” card to the other family member or model using the child’s AAC system. Be sure the family member hands the child the controller immediately. — When the child’s turn is over, model saying, “Can I have a turn?” and hold out your hand. — When your turn is done, hold on to the device and wait a few seconds. — If the child responds with “Can I have a turn?” immediately hand over the controller. — If the child does not respond, the other family member can prompt the child by: £ Pointing to the “Can I have a turn?” cue card or AAC system picture/button £ Say just the first two or three words, “Can I ____” Activity #3: Teaching Turn-Taking -- Accepting and Requesting a Turn — During each turn, you can take a few seconds to think about at to do before going. — Just like in the example above, pat your chest and say, “My turn!” as you pick up the chip. — When finished, pass a chip or puzzle piece to the child, point, and say, “Your turn!” — Then, as the child’s waiting ability grows, move to card or board games with around 3 players where the wait time stretches out a bit longer. £ Candy Land £ Jenga £ Operation £ Uno — This time, you say the name of the person who goes next as well as “My turn!” and “Your turn!” — Use a timer for when a child must wait longer periods of time between turns. This way, the child can see how much time is left before it is their turn. — Remember to be patient! Young children typically have short attention spans that slowly grows over time.  — If the child finishes the sentence, hands the card over, or uses an AAC system to communicate “Can I have a turn?” immediately hand over the controller and continue. — If the child does not respond, the other family member can model handing the “Can I have a turn?” card over or model using the child’s AAC system. — Continue with the activity for a few more turns but try to end the activity before the child gets bored or wanders off. Social Skill Extension Activity: Turn taking is for more than just playing games though. Turn taking is a critical component to our conversations with others. After all, a conversation is much like a tennis match where each person takes a turn making a comment or asking a question and someone else responds with their own comment or question. Some children with ASD may want to dominate the conversation and the situation might end up much more one-sided. Try these activities to encourage more interactive conversations. This is a great activity for building a story together during dinner or while driving in the car. One person starts the story with just a single sentence or two. The next person adds their own sentence of turn and so on and so on. This can help the child practice turn taking and cooperation but also encourages the child to use interesting vocabulary and silly sentences. This activity can be easily adapted for children who use cue cards, sentence strips, choice boards, or AAC! Extension Activity #1: Group Story Telling — A talking stick is a very concrete way of helping a child understand how a conversation flows back and forth between two or more people. You can use any old stick or make your own fancy talking stick with a paper towel roll. The rule of this activity is that only the person holding the stick may speak. Start with just 2 people and later add more family members. A great time to do this activi- ty is after school or during a family meal when everyone is often talking about their day. — Start the activity by holding the stick and saying, “Ok, my turn.” — Set a timer for 30 seconds as you begin to talk. — When the timer goes off, hand the talking stick to the next person and say, “Ok, you’re turn.” — Set a timer for 30 seconds as they begin to talk. — Practice going back and forth between 2 or more people for a few more turns. If the child speaks while someone else is holding the stick, simply remind the child of the rules and that they must wait to speak. Continue the activity for a few turns but end the activity before the child gets bored or wanders away. Extension Activity #2: Talking Stick  — View Video - VCU Autism Center for Excellence -- https://vcuautismcenter.org/te/how_to/simpleVideo.cfm?video=27 — Autism Q&A: Providing Choices -- https://vcuautismcenter.org/resources/factsheets/printView.cfm/1194 — Autism Q&A: Introduction to Teaching Young Children with Autism -- https://vcuautismcenter.org/resources/factsheets/ printView.cfm/1077 — Functions of Communcation - VCU Autism Center for Excellence -- https://vcuautismcenter.org/ta/vagoals/ communication/...to.../functions.cfm — How To Video Series - VCU Autism Center for Excellence -- https://vcuautismcenter.org/te/how_to/ — Evidence-Based Practices - VCU Autism Center for Excellence -- https://vcuautismcenter.org/te/topics/evidence.cfm — Communication - VCU Autism Center for Excellence -- https://vcuautismcenter.org/resources/communication.cfm Links to resources on our website! Virginia Commonwealth University’s Autism Center for Excellence (VCU-ACE) is funded by the Virginia Department of Education, contract # 881-APE61172-H027A200107. Virginia Commonwealth University is an equal opportunity/affirmative action institution providing access to education and employment without regard to age, race, color, national origin, gender, religion, sexual orientation, veteran’s status, political affiliation, or disability. If special accommodations are needed, please contact Carol Schall at (804) 828-1851 VOICE or (804) 828-2494 TTY. — Developing meaningful relationships with others includes having more in-depth conversations than just greetings and polite exchanges about well-being or the weather. Conversations between family mem- bers and friends include many back and forth exchanges that can often be fast-paced. To help prepare a child with ASD for these types of conversations, it will be necessary to role-play and practice. — To start this activity, make sure children who use AAC have access to all the necessary signs, pictures, or vocabulary on their device. For children who are verbal but may struggle with knowing what to say when, prepare cue cards, sentence strips, choice boards, or even just a whiteboard with options for keeping a conversation going. You’ll need to consider all the things a child might want to say to a friend such as, “What did you do this weekend?” “I watched the new ______ movie.” “Have you seen that movie yet?” “Did you like it?” and “I loved / hated it!” “The action was awesome!” — To begin, start by practicing different greetings. Remember, we use different greetings for more formal situations than what we use with our friends. — Next, practice different scenarios such as seeing a friend early Monday morning at school and asking what everyone did over the weekend. — If the child responds, keep the conversation going with a comment. Remember, conversations are not a series of questions. We make lot of different comments in a conversation. Some act as fillers while others can console, agree, disagree, and more. — If the child does not respond, prompt the child by: £ Pointing to the appropriate cue card, sentence strip, or whiteboard comment/question £ Modeling how to use the child’s AAC system £ You can also say just the first word or two of the comment/question such as “I went…” — If the child responds, continue the conversation. — For more information about teaching a child to ask Wh- questions or make comments, check out our other toolkits, ___________ and ____________. Extension Activity #3: Conversational Skills